A nurse is preparing to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 ml to an adult client following hip arthroplasty.
Which of the following actions should the nurse plan to take?

Aspirate carefully after inserting the needle into the client’s skin.

Administer the injection in the client’s thigh.

Insert the needle at 90 degrees.

Expel the air bubble from the prefilled syringe before injecting.

Answer and Explanation

The Correct Answer is C

This is because enoxaparin is administered subcutaneously, which means under the skin, and the needle should be inserted fully into the skin to ensure proper delivery of the drug.

Choice A is wrong because aspirating (pulling back on the plunger) after inserting the needle is not recommended for subcutaneous injections of enoxaparin, as it may increase the risk of bleeding or bruising.

Choice B is wrong because administering the injection in the client’s thigh is not the preferred site for enoxaparin. The preferred site is the abdomen, at least 2 inches away from the navel, as it has more fatty tissue and less blood vessels than other areas.

Choice D is wrong because expelling the air bubble from the prefilled syringe is not necessary for enoxaparin. The air bubble helps to ensure that the entire dose of enoxaparin is injected and prevents blood from entering the syringe.

Normal ranges for enoxaparin dosage depend on the indication and the patient’s weight, but for prophylaxis of deep vein thrombosis after hip arthroplasty, the usual dose is 40 mg once a day for 3 weeks.

The prefilled syringe of enoxaparin 40 mg/0.4 ml contains the correct dose for this indication.

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Correct Answer is A

Explanation

Digoxin is a medication that can help the heart pump more blood and slow down the heart rate in certain conditions, such as heart failure and atrial fibrillation.However, digoxin has a narrow therapeutic range, which means that too much or too little of it can be harmful.The therapeutic range of digoxin levels in the blood is 0.5-2 ng/mL, and the toxic level is >2.4 ng/mL.Digoxin should be held if the resting apical pulse of an infant is <90 bpm, an older child is <70 bpm, or an adult is <60 bpm.A pulse of 48/min in an adult is too low and could indicate digoxin toxicity, which can cause life-threatening arrhythmias. Therefore, the nurse should withhold the dose and notify the health care provider immediately.

Choice B is wrong because notifying the health care provider and monitoring the patient’s vital signs are not enough.

The nurse should also withhold the dose to prevent further exposure to digoxin.

Choice C is wrong because rechecking the pulse, making sure to count for 1 full minute, is not necessary.The nurse should already have counted the pulse for 1 full minute before administering digoxin, as per standard procedure.

Choice D is wrong because administering the dose could worsen the patient’s condition and increase the risk of digoxin toxicity and arrhythmias.

A. Atorvastatin. B. Niacin. C. Gemfibrozil D. Amlodipine.

Correct Answer is A

Explanation

Atorvastatin is a type ofstatin, which are the most potent antilipidemic agents, and have proven to lower the risk of myocardial infarction by reducing the levels of low-density lipoprotein (LDL) cholesterol and triglycerides in the blood.Statins also slightly increase the level of high-density lipoprotein (HDL) cholesterol, which is beneficial for cardiovascular health.

Choice B, niacin, is a type ofnicotinic acid, which can lower LDL cholesterol and triglycerides, and increase HDL cholesterol, but it is less effective than statins and has more side effects, such as flushing, itching, and liver toxicity.

Choice C, gemfibrozil, is a type offibric acid derivative, which can lower triglycerides and increase HDL cholesterol, but have little effect on LDL cholesterol.They are mainly used for patients with high triglyceride levels or low HDL cholesterol levels.

Choice D, amlodipine, is not an antilipidemic agent at all.It is a type ofcalcium channel blocker, which is used to treat hypertension and angina by relaxing the blood vessels and reducing the workload of the heart.

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A nurse is preparing to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 ml to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take?

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The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min. What should the nurse do next?

Correct Answer is A

Explanation

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Correct Answer is A

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A nurse is preparing to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 ml to an adult client following hip arthroplasty.
Which of the following actions should the nurse plan to take?