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?

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.

Anticoagulants are medicines that increase the time it takes for blood to clot.They do not dissolve existing clots, but they can stop them from getting bigger or prevent new clots from forming.Anticoagulants work by interfering with different steps of the blood coagulation pathway, which is a complex process that involves many clotting factors.

Choice A is wrong because anticoagulants do not dissolve existing clots.To dissolve clots, you need medicines called thrombolytics or fibrinolytics, which break down the fibrin that holds the clots together.

Choice B is wrong because anticoagulants do not transport platelets.

Platelets are blood cells that help with clotting by sticking together and forming a plug at the site of an injury.Anticoagulants may affect the function of platelets, but they do not move them around.

Choice D is wrong because anticoagulants do not increase blood viscosity.

Viscosity is a measure of how thick and sticky a fluid is.

Anticoagulants are sometimes called blood thinners, but they do not actually change the viscosity of blood.They just make it less likely to clot.

Normal ranges for blood clotting tests vary depending on the type of test and the laboratory that performs it.

Some common tests and their normal ranges are:

• Prothrombin time (PT): 11 to 13.5 seconds

• International normalized ratio (INR): 0.8 to 1.2

• Activated partial thromboplastin time (aPTT): 25 to 35 seconds

• Anti-factor Xa: 0.3 to 0.7 units/mL

• D-dimer: less than 0.5 mcg/mL