The nurse is scheduled to administer the patient’s next dose of vancomycin at 9:30 a.m. At what time should the nurse draw the patient’s blood to check the trough vancomycin level?

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.