During the assessment of the patient, the nurse finds nonpalpable pedal pulses in the affected leg. How will the nurse proceed with assessment?

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.

A. "Your veins are not functioning properly. Lack of venous blood volume causes these ulcers": While venous insufficiency contributes to the development of venous ulcers, the primary issue is not necessarily a lack of venous blood volume but rather impaired venous return due to valve dysfunction.

B. "Your veins are weaker and blood is not moving up as it should. The congestion in your veins causes the ulcers to form.": This explanation accurately describes the pathophysiology of venous ulcers. Venous insufficiency leads to venous congestion, which causes increased pressure in the veins of the lower extremities. This pressure can result in the breakdown of skin and the formation of ulcers, typically around the ankles.

C. "Because the veins are not working properly, there is not enough oxygen going to the skin of your legs.": While venous insufficiency can affect tissue oxygenation to some extent, the primary mechanism leading to venous ulcers is venous congestion and increased pressure in the lower extremities, rather than insufficient oxygen delivery.

D. "Your veins clogged so the body causes the arteries to swell and the excess oxygen in the blood causes the ulcers.": This explanation does not accurately describe the pathophysiology of venous ulcers. Venous ulcers result from impaired venous return and venous congestion, not arterial swelling or excess oxygen in the blood.