The nurse is administering medications to the client and is monitoring potential adverse effects of medications.

For each body system below, click to specify the assessment findings that could indicate a serious adverse reaction. Each body system may support more than 1 potential assessment finding. To deselect a finding click on the finding again.

 

Body system	Findings
Head. Eyes. Ears. Nose, and Throat (HEENT)	Yellowing of the eyes Blurred vision Dry eyes
Gastrointestinal	Abdominal pain Weight gain
Hematologic	Increased bruising Increased bleeding tendancies Insomnia
Genitourinary	Darkening of the urine Urinary frequency

A) Decreased platelets: A decrease in platelet count (thrombocytopenia) is often associated with conditions such as bleeding disorders, bone marrow problems, or certain infections, but it is not a direct indicator of infection. While infections can cause a drop in platelets, this is not a specific or primary indicator of infection.

B) Decreased hemoglobin: A decrease in hemoglobin is typically indicative of anemia, which can result from a variety of causes, including nutritional deficiencies, chronic disease, or blood loss. While anemia can be associated with some infections, it is not a specific indicator of infection.

C) Increased erythrocyte sedimentation rate (ESR): An increased ESR is a nonspecific indicator of inflammation in the body and can be associated with infections, autoimmune diseases, and other inflammatory conditions. It is commonly elevated during infections, as the body responds to the inflammatory process. Therefore, an elevated ESR is a useful laboratory finding when suspecting an infection.

D) Increased iron level: Increased iron levels are typically associated with conditions such as hemochromatosis or iron overload, not with infections. During infections, iron levels can actually decrease due to the body's response to restrict iron availability to pathogens.

A) Cimetidine: Cimetidine is an H2 receptor antagonist used to treat gastrointestinal issues like heartburn or ulcers. It does not have a known significant interaction with enoxaparin. Therefore, it is generally considered safe to use with enoxaparin, but it may require monitoring for other potential drug interactions, such as those with warfarin, not enoxaparin specifically.

B) Docusate: Docusate is a stool softener commonly used to prevent constipation. It does not interact with enoxaparin and is safe for use with the medication. It helps relieve constipation without increasing bleeding risks, which is a concern with certain other medications.

C) Calcium supplement: Calcium supplements are generally safe to use with enoxaparin. There is no significant interaction between calcium and enoxaparin, and calcium is often recommended for clients to maintain bone health, especially in those who are at risk of osteoporosis. Therefore, calcium supplements do not pose a risk when taken with enoxaparin.

D) Naproxen: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that increases the risk of bleeding. NSAIDs, including naproxen, inhibit platelet aggregation, which can potentiate the anticoagulant effects of enoxaparin and increase the risk of bleeding. Therefore, naproxen should be avoided in clients taking enoxaparin.