A nurse is providing education of enoxaparin to a patient diagnosed with deep venous thrombosis. Which statement by the patient indicates understanding of the teaching?

"It eliminates the clotting factors."

"This medication will keep the blood clot from growing larger."

"This medication will decrease my risk for bleeding."

"I will get this medication in my veins."

Answer and Explanation

The Correct Answer is B

A. "It eliminates the clotting factors." - This statement suggests a misunderstanding of how enoxaparin works. Enoxaparin is a low molecular weight heparin that does not eliminate clotting factors but rather inhibits the activity of factor Xa, a key enzyme involved in the coagulation cascade. By inhibiting factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots. It does not eliminate existing clotting factors from the bloodstream.

B. "This medication will keep the blood clot from growing larger." - This statement demonstrates a correct understanding of enoxaparin's mechanism of action. Enoxaparin is an anticoagulant medication that works by preventing the enlargement of existing blood clots. By inhibiting the activity of factor Xa, enoxaparin prevents the conversion of prothrombin to thrombin, thereby reducing the formation of fibrin clots and preventing existing clots from growing larger.

C. "This medication will decrease my risk for bleeding." - This statement is incorrect. Enoxaparin, like other anticoagulants, actually increases the risk of bleeding due to its mechanism of action. By inhibiting the coagulation cascade, enoxaparin prolongs the time it takes for blood to clot, which can lead to an increased risk of bleeding, particularly in patients who are predisposed to bleeding or are taking other medications that affect clotting.

D. "I will get this medication in my veins." - This statement is incorrect. Enoxaparin is administered subcutaneously, not intravenously. It is usually injected into the fatty tissue of the abdomen or thigh using a prefilled syringe with a short, thin needle. The subcutaneous route of administration allows for slow absorption and sustained anticoagulant effects over time.

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Correct Answer is C

Explanation

A. A 29-year-old female who reports drinking a glass of wine with dinner: While excessive alcohol consumption can contribute to hypertension, moderate alcohol intake, such as drinking a glass of wine with dinner, is not typically a significant risk factor for hypertension in the absence of other contributing factors. Therefore, this individual may not be considered at high risk for hypertension solely based on this information.

B. A 35-year-old male who works 50 hours a week: While chronic stress from long work hours can potentially contribute to hypertension, working 50 hours a week alone may not be sufficient to significantly increase the risk of hypertension, especially in the absence of other significant risk factors. Therefore, this individual may not be considered at high risk for hypertension solely based on this information.

C. A 50-year-old male who reports smoking 2 packs of cigarettes a day: Smoking is a significant risk factor for hypertension. Nicotine in cigarettes can cause blood vessels to narrow, leading to increased blood pressure. Smoking also damages blood vessel walls, making them more susceptible to plaque buildup and narrowing, further increasing the risk of hypertension. Therefore, this individual is at high risk for hypertension due to their smoking habit.

D. A 30-year-old female with a family history of diabetes mellitus: While a family history of diabetes mellitus may increase the risk of developing hypertension due to shared risk factors such as obesity and unhealthy lifestyle habits, it is not as directly associated with hypertension as smoking. Additionally, the individual's age and family history alone may not be sufficient to determine a significant risk for hypertension without additional information about lifestyle and other risk factors.

A. Reluctance to monitor blood pressure at home B. Reduction in work hours C. Initiation of an exercise plan D. Preference for a low sodium diet

Correct Answer is A

Explanation

A. Reluctance to monitor blood pressure at home: One barrier to blood pressure management in patients newly diagnosed with hypertension is reluctance or resistance to monitor blood pressure at home. Home blood pressure monitoring is an essential component of hypertension management as it allows patients and healthcare providers to track blood pressure trends, assess the effectiveness of treatment, and make adjustments as needed. However, some patients may feel apprehensive about self-monitoring or may lack understanding of its importance, leading to reluctance to engage in this aspect of their care. Addressing this barrier requires patient education, encouragement, and support to promote the benefits of home blood pressure monitoring and empower patients to take an active role in managing their hypertension.

B. Reduction in work hours: While work-related stress and long working hours can contribute to hypertension, a reduction in work hours would not typically be considered a barrier to blood pressure management, especially if it allows for better stress management, lifestyle modifications, and adherence to treatment regimens.

C. Initiation of an exercise plan: Starting an exercise plan is generally considered a positive step in blood pressure management rather than a barrier. Regular physical activity helps lower blood pressure, improve cardiovascular health, and promote overall well-being. However, barriers related to exercise adherence, such as lack of time, motivation, or access to suitable facilities, could hinder effective blood pressure management.

D. Preference for a low sodium diet: Opting for a low sodium diet is beneficial for individuals with hypertension as it helps reduce blood pressure levels and lowers the risk of cardiovascular events. Therefore, a preference for a low sodium diet would not be considered a barrier to blood pressure management. However, barriers related to dietary adherence, such as taste preferences, cultural influences, or difficulty in meal planning, may need to be addressed to support long-term dietary changes and improve blood pressure control.

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