A nurse is reinforcing teaching about the facility's fire intervention plan with new assistive personnel. Which of the following instructions the nurse include in the teaching?

Rationale:

A. 300 mg PO od: The dose is written clearly with no trailing zeros, and “od” (once daily) is acceptable though “daily” is preferred for clarity. This entry minimizes risk of misinterpretation and decimal errors.

B. 3.0 mg PO gd: Using a trailing zero (3.0 mg) increases the risk of a tenfold dosing error if the decimal point is missed. Also, “gd” is an incorrect abbreviation; “daily” or “once daily” should be used.

C. 10.000 units IV dally: Writing “10.000” with multiple trailing zeros is dangerous because the decimal point might be overlooked, causing a ten-thousand-fold error. Also, “dally” is a misspelling of “daily.”

D. 05 mL IM daily: Leading zeros before whole numbers (05 mL) are unnecessary and can cause confusion. The correct notation is “5 mL.” Leading zeros should only be used before decimals less than one (e.g., 0.5 mL).

Rationale:

A. Docusate: Docusate is a stool softener that does not interfere with coagulation or increase bleeding risk. It is often safely used in clients taking anticoagulants to prevent straining during bowel movements, which is especially important in post-operative or cardiovascular patients.

B. Cimetidine: While cimetidine may interact with some medications metabolized by the liver, it does not significantly affect bleeding risk when used with enoxaparin. However, it should still be used cautiously due to potential drug interactions and altered metabolism.

C. Calcium supplement: Calcium supplements do not interfere with the anticoagulant action of enoxaparin. They are commonly used for bone health and are generally safe, provided they are taken at recommended doses without excessive vitamin D.

D. Garlic: Garlic, especially in supplement form, can have antiplatelet effects and may increase the risk of bleeding when taken with anticoagulants like enoxaparin. Clients should be advised to avoid herbal products like garlic, ginkgo, or ginseng without provider approval.