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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Hypokalemia is a condition of low potassium levels in the blood, which can be caused by diuretics such as furosemide (Lasix) that increase the excretion of potassium in the urine. Potassium is an important electrolyte that helps regulate the function of nerves and muscles, including the heart.Low potassium levels can cause symptoms such as confusion, tremors, muscle cramps, and nausea, which are consistent with the patient’s presentation.
Choice B, renal failure, is wrong because furosemide is used to treat fluid retention and edema caused by kidney disease, not to cause it.Renal failure would also cause symptoms such as decreased urine output, swelling, fatigue, and shortness of breath, which are not mentioned in the question.
Choice C, hyperkalemia, is wrong because hyperkalemia is a condition of high potassium levels in the blood, which can be caused by kidney disease or certain medications that decrease the excretion of potassium in the urine.Hyperkalemia can cause symptoms such as weakness, irregular heartbeat, paralysis, and chest pain, which are different from the patient’s symptoms.
Choice D, heart failure, is wrong because furosemide is also used to treat fluid retention and edema caused by heart failure, not to cause it.Heart failure would also cause symptoms such as shortness of breath, coughing, fatigue, and rapid weight gain, which are not mentioned in the question.
Normal ranges for potassium levels in the blood are 3.5 to 5.0 milliequivalents per liter (mEq/L) for adults and 3.4 to 4.7 mEq/L for children.
A level below 3.5 mEq/L is considered hypokalemic and a level above 5.0 mEq/L is considered hyperkalemic.
Correct Answer is D
Explanation
Report any muscle pain or weakness to the healthcare provider.This is because simvastatin This is because simvastatin can cause a rare but serious side effect of muscle damage (rhabdomyolysis), which can lead to kidney failure.Muscle pain or weakness can be signs of muscle breakdown and kidney damage, and should be reported to the healthcare provider as soon as possible.
Choice A is wrong because changing position slowly when rising from a chair is not related to simvastatin.This is a precaution for people who take medications that lower blood pressure, such as diuretics or beta blockers, to prevent dizziness or fainting.
Choice B is wrong because maintaining a steady intake of green leafy vegetables is not specific to simvastatin.This is a general dietary recommendation for people who take anticoagulants, such as warfarin, to prevent bleeding complications.
Choice C is wrong because consuming no more than 1 L/day of fluid is not advised for people who take simvastatin.This is a restriction for people who have heart failure or kidney disease, to prevent fluid overload.People who take simvastatin should drink enough fluids to stay hydrated and avoid dehydration, which can increase the risk of kidney damage.
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