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?

Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.

Choice A. Administer medication is wrong because it could harm the patient as explained above.

Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.

The nurse should not delay notifying the provider about the patient’s condition.

Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.

The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.

Taking a loop diuretic with supper is not advisable because it can cause nocturia, which is the need to urinate frequently at night. This can disrupt sleep and affect quality of life.Loop diuretics should be taken in the morning or early afternoon to avoid this problem.

Choice A is wrong because weighing oneself each day before breakfast is a good way to monitor fluid balance and detect any signs of fluid retention or dehydration.This can help adjust the dose of the loop diuretic as needed.

Choice B is wrong because contacting the healthcare provider if shortness of breath returns is a sensible precaution and indicates awareness of the symptoms of worsening heart failure.Shortness of breath is caused by fluid accumulation in the lungs, which loop diuretics help to prevent or reduce.

Choice C is wrong because having a banana with breakfast every morning is a good source of potassium, which can help prevent hypokalemia, a common side effect of loop diuretics.Loop diuretics increase the excretion of potassium in the urine, which can lead to low blood levels of potassium and cause muscle weakness, cramps, fatigue, arrhythmias, and increased sensitivity to digoxin.