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 C
Explanation
This is because potassium sparing diuretics do not lower potassium levels in the blood, unlike other types of diuretics.Potassium is an essential electrolyte that serves nerve and muscular functions and is regulated by the kidneys.Low potassium levels can cause irregular heartbeats and other problems. Therefore, patients taking potassium sparing diuretics should avoid food sources that are high in potassium, such as bananas, avocados, spinach, and potatoes.
Choice A is wrong because thiazide diuretics, such as hydrochlorothiazide, can cause low potassium levels in the blood.
Patients taking thiazide diuretics may need to take potassium supplements or eat more potassium-rich foods to prevent hypokalemia.
Choice B is wrong because osmotic diuretics, such as mannitol, do not affect potassium levels in the blood.
They work by increasing the amount of water in the urine, but do not alter the electrolyte balance.
Osmotic diuretics are mainly used to treat cerebral edema and glaucoma.
Choice D is wrong because loop diuretics, such as furosemide, can also cause low potassium levels in the blood.
They work by inhibiting the reabsorption of sodium and water in the loop of Henle, a part of the kidney.
Loop diuretics are used to treat edema and heart failure.
Normal ranges for potassium in the blood are 3.5 to 5.0 millimoles per liter (mmol/L).
Correct Answer is D
Explanation
This is because digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and require dose adjustment or discontinuation of the medication.Digoxin helps make the heart beat stronger and with a more regular rhythm by inhibiting sodium-potassium ATPase in cardiac cells.It is used to treat heart failure and atrial fibrillation.
Choice A is wrong because increasing sodium intake can worsen fluid retention and exacerbate heart failure symptoms.Patients with heart failure should follow a low-sodium diet to reduce the workload on the heart.
Choice B is wrong because checking pulse rate for 30 seconds and multiplying result by 2 is not accurate enough to monitor the effects of digoxin.
Patients taking digoxin should check their pulse rate for one full minute before taking each dose and record it daily.If the pulse rate is too fast or too slow, they should contact their provider.
Choice C is wrong because taking digoxin with food may reduce its absorption and effectiveness.Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal.If nausea occurs, it may be a sign of digoxin toxicity and should be reported to the provider.
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