The healthcare provider prescribes enoxaparin sodium 80 mg SUBQ three times daily. The nurse is preparing a preloaded 1 mL syringe labeled “Enoxaparin sodium injection, USP 60 mg/0.6 mL.”

How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)

Choice A reason: Withholding the scheduled dose and notifying the healthcare provider is the correct action because the client’s heart rate is significantly low at 48 beats per minute. Labetalol, a beta-blocker, can further reduce the heart rate, potentially leading to bradycardia or other cardiac complications. It is crucial to inform the healthcare provider to reassess the medication regimen and ensure the client’s safety.

Choice B reason: Administering the dose and monitoring the client’s blood pressure regularly is not advisable in this scenario. Although monitoring blood pressure is important, the primary concern here is the client’s low heart rate. Administering labetalol could exacerbate bradycardia, leading to severe complications.

Choice C reason: Assessing for orthostatic hypotension before administering the dose is a good practice but not the most critical action in this situation. The client’s low heart rate poses a more immediate risk than orthostatic hypotension. Therefore, withholding the medication and notifying the healthcare provider is a higher priority.

Choice D reason: Applying a telemetry monitor before administering the dose is useful for continuous cardiac monitoring, but it does not address the immediate concern of the client’s low heart rate. The priority should be to withhold the medication and consult the healthcare provider to prevent potential bradycardia.

Choice A reason: Baclofen is a muscle relaxant that can cause side effects such as dizziness and fatigue, especially when starting the medication or adjusting the dose1. These symptoms are usually temporary and may subside as the body adjusts to the medication. Advising the client to avoid hazardous activities, such as driving or operating heavy machinery, helps prevent accidents and ensures safety while the body adapts to the new medication.

Choice B reason: Increasing the intake of fluids and high-protein foods is generally good advice for overall health but is not specifically related to managing the side effects of baclofen. While staying hydrated and maintaining a balanced diet can support overall well-being, it does not directly address the dizziness and fatigue caused by baclofen.

Choice C reason: Stopping the medication immediately is not recommended without consulting a healthcare provider. Abruptly discontinuing baclofen can lead to withdrawal symptoms, including hallucinations and seizures4. It is important to follow a healthcare provider’s guidance when adjusting or stopping any medication.

Choice D reason: Obtaining transportation to the emergency department is not necessary unless the symptoms are severe or accompanied by other concerning signs, such as difficulty breathing or chest pain. Mild to moderate dizziness and fatigue are common side effects of baclofen and can typically be managed with caution and monitoring.