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 D
Explanation
Angiotensin receptor blockers (ARBs) are a class of drugs that block the action of angiotensin II, a hormone that causes blood vessels to constrict and raise blood pressure. Examples of ARBs include losartan, valsartan, candesartan, and irbesartan.ARBs are used to treat hypertension, heart failure, and chronic kidney disease.
Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.
Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.
Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.
Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.
Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.
Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.
Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.
Examples of ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.ACE inhibitors are used to treat hypertension, heart failure, and chronic kidney disease.
Correct Answer is D
Explanation
The correct answer is Choice D: Headache.
Choice A rationale: Nausea is not a common adverse effect of sublingual nitroglycerin. Nausea may occur in some patients, but it is usually mild and transient.Nausea may be related to the vasodilatory effects of nitroglycerin, which can cause hypotension and reflex tachycardia1. Nausea may also be caused by other factors, such as anxiety, stress, or food intolerance.Nausea is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice B rationale: Bradycardia is not a common adverse effect of sublingual nitroglycerin. Bradycardia is a slow heart rate, usually defined as less than 60 beats per minute.Bradycardia may occur in some patients who take nitroglycerin, especially in combination with other drugs that affect the heart rate, such as beta-blockers, calcium channel blockers, or digoxin3. Bradycardia may also be caused by other factors, such as vagal stimulation, hypothyroidism, or electrolyte imbalance.Bradycardia is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice C rationale: Hypertension is not a common adverse effect of sublingual nitroglycerin. Hypertension is a high blood pressure, usually defined as more than 140/90 mmHg.Hypertension may occur in some patients who take nitroglycerin, especially in those who have a history of hypertension, renal impairment, or volume overload4. Hypertension may also be caused by other factors, such as stress, pain, or caffeine intake.Hypertension is not a specific indicator of nitroglycerin toxicity or overdose2.
Choice D rationale: Headache is a common adverse effect of sublingual nitroglycerin.Headache may occur in up to 80% of patients who take nitroglycerin, especially during the first few days of therapy or after an increase in dose5. Headache may be related to the vasodilatory effects of nitroglycerin, which can cause cerebral vasodilation and increased intracranial pressure. Headache may also be caused by other factors, such as dehydration, sinusitis, or migraine. Headache is usually mild to moderate in intensity and can be relieved by analgesics, such as acetaminophen or aspirin.Headache is not a specific indicator of nitroglycerin toxicity or overdose
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