Which factor contributes to the formation of a pressure injury when a patient’s body slides downward to the foot of the bed?

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.

Choice A rationale:

STAT orders are urgent and require immediate action. They are typically used for life-threatening situations or when a rapid response is needed to prevent serious harm. In this case, an EKG is important for patients admitted to the cardiac unit, but it is not necessarily an urgent procedure that requires immediate action in all cases.

STAT orders are often given verbally or over the phone, and they are typically written in all capital letters with the word "STAT" prominently displayed.

Examples of STAT orders include medications for cardiac arrest, intubation for respiratory distress, or emergency surgery for a ruptured appendix.

Choice B rationale:

PRN orders are "as needed" orders, meaning they are only carried out when a specific condition or symptom arises. They are not routinely implemented for all patients in a particular unit or setting.

PRN orders allow for flexibility in treatment plans and can help to manage pain, nausea, anxiety, or other symptoms that may fluctuate over time.

Examples of PRN orders include pain medication, anti-nausea medication, or sedatives.

Choice C rationale:

One-time orders are administered only once and are not repeated. They are often used for procedures, diagnostic tests, or medications that are not required on an ongoing basis.

In this case, an EKG is typically a one-time order for patients outside of the cardiac unit, but it becomes a standing order for patients admitted to the cardiac unit due to the increased importance of cardiac monitoring in this setting.

Examples of one-time orders include a chest X-ray, a blood draw, or a dose of antibiotics.

Choice D rationale:

Standing orders are routine orders that are implemented for all patients in a particular unit or setting, unless otherwise specified. They are designed to provide consistent and standardized care, and they often reflect best practices or guidelines for a specific patient population.

Standing orders can help to streamline care processes, reduce the need for individual orders, and ensure that patients receive necessary treatments or interventions without delay.

In this case, the standing order for an EKG upon admission to the cardiac unit ensures that all patients receive this important cardiac assessment, even if the ordering provider does not specifically write an order for it.

Other examples of standing orders in a cardiac unit might include daily weights, regular vital sign checks, or administration of cardiac medications.