The nurse is to administer enoxaparin 40 mg subcutaneously to the patient. Which technique is correct?
The nurse aspirates immediately prior to injecting the medication.
The nurse gently massages the injection site immediately afterward.
The nurse draws up the medication into a 1-mL syringe with a 32-gauge needle.
The nurse injects the medication into the soft tissue of the patient’s abdomen.
The Correct Answer is D
Choice A rationale:
Aspirating prior to injecting enoxaparin is not recommended.
Aspiration was once a common practice to check if a needle had entered a blood vessel.
However, research has shown that aspiration is not necessary for subcutaneous injections and may even be harmful. It can cause pain, bruising, and hematoma formation.
Additionally, aspirating can increase the risk of needlestick injuries.
For these reasons, aspiration is no longer recommended for subcutaneous injections of enoxaparin or other anticoagulants.
Choice B rationale:
Massaging the injection site after administering enoxaparin is not recommended. Massaging can increase the risk of bruising and hematoma formation.
It can also cause the medication to be absorbed too quickly, which can increase the risk of bleeding.
The best practice is to apply gentle pressure to the injection site with a dry gauze pad for a few seconds after the injection. This will help to prevent bleeding and bruising.
Choice C rationale:
The size of the syringe and needle used to administer enoxaparin is not specified in the question. However, a 1-mL syringe with a 32-gauge needle is a common choice for subcutaneous injections.
This size syringe is small enough to be easy to handle, and the 32-gauge needle is thin enough to minimize discomfort.
Choice D rationale:
The abdomen is the preferred site for subcutaneous injections of enoxaparin.
The abdomen has a large surface area of soft tissue, which makes it easy to inject the medication.
The abdomen is also relatively free of blood vessels and nerves, which reduces the risk of bruising, bleeding, and pain. Other potential injection sites for enoxaparin include the upper arms, thighs, and buttocks.
However, the abdomen is generally the preferred site.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Incorrect. Patients who develop tolerance to a medication do not typically maintain a stable dose over time. Instead, they often require increasing doses to achieve the same effect.
Physiological adaptation: The body adapts to the presence of the medication, leading to a decreased response over time. This adaptation can occur at various levels, including receptor downregulation, changes in enzyme activity, or alterations in neurotransmitter release.
Individual variability: The rate and extent of tolerance development vary significantly among individuals, influenced by factors such as genetics, age, overall health, and medication type.
Choice B rationale:
Incorrect. Impaired liver or kidney function can affect drug metabolism and elimination, but this is not the primary mechanism of tolerance.
Metabolic impairment: Liver or kidney dysfunction can lead to drug accumulation in the body, potentially increasing the risk of side effects or toxicity. However, this does not necessarily cause tolerance, which is a specific phenomenon of decreased responsiveness to the medication's effects.
Choice C rationale:
Correct. This statement accurately describes the hallmark characteristic of tolerance.
Dose escalation: As tolerance develops, patients often require higher doses of the medication to achieve the same therapeutic effect. This can lead to a cycle of increasing doses and potential risks of adverse effects.
Clinical implications: Tolerance is a significant consideration in medication management, as it can affect treatment efficacy, adherence, and the risk of side effects.
Choice D rationale:
Incorrect. Tolerance can develop even when patients adhere strictly to their prescribed medication regimen. It is a physiological phenomenon that is not solely dependent on patient behavior.
Adherence vs. tolerance: While non-adherence can contribute to treatment failure, it is not the underlying cause of tolerance.
Correct Answer is A
Explanation
Step 1: Convert the prescribed dose to milligrams. 400 mcg = 0.4 mg (since 1 mg = 1000 mcg)
Step 2: Compare the prescribed dose to the pill strength. The prescribed dose is 0.4 mg.
The pill strength is 0.4 mg.
Step 3: Determine the number of pills needed.
Since the prescribed dose and pill strength are equal, only one pill is needed to administer the correct dose.
Rationale for Choice A:
Correct: One pill of 0.4 mg will provide the exact dose of 400 mcg that has been prescribed.
Direct match: The pill strength matches the prescribed dose, eliminating the need for any calculations or adjustments.
Therapeutic equivalence: Administering one pill ensures that the patient receives the intended amount of medication to achieve the desired therapeutic effect.
Adherence to prescription: Conforms to the healthcare provider's instructions, promoting accurate and safe medication administration.
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