The patient is receiving enoxaparin (Lovenox) subcutaneously every 12 hours following knee replacement surgery. The patient is monitored for.

Clotting at the incision site.

Increased pain.

Gingival hyperplasia.

Signs and symptoms of bruising and bleeding.

Answer and Explanation

The Correct Answer is D

A. Clotting at the incision site. Enoxaparin (Lovenox) is an anticoagulant medication used to prevent blood clots, particularly deep vein thrombosis (DVT) and pulmonary embolism (PE), which are common complications following orthopedic surgeries like knee replacement. Monitoring for clotting at the incision site is essential to ensure that the medication is effectively preventing excessive clot formation while also ensuring that the patient does not experience excessive bleeding.

B. Increased pain. While increased pain could be a concern postoperatively, particularly after a surgical procedure like knee replacement, it is not a specific monitoring parameter for enoxaparin administration. Pain management is typically addressed separately, and increased pain may indicate issues such as inadequate analgesia, surgical complications, or other factors unrelated to enoxaparin therapy.

C. Gingival hyperplasia. Gingival hyperplasia refers to an overgrowth of gum tissue and is not directly associated with enoxaparin therapy. This side effect is more commonly associated with certain medications such as phenytoin and cyclosporine rather than anticoagulants like enoxaparin. Monitoring for gingival hyperplasia would not be relevant in this context.

D. Signs and symptoms of bruising and bleeding. This is the correct answer. Enoxaparin is an anticoagulant medication, which increases the risk of bleeding. Therefore, monitoring for signs and symptoms of bruising and bleeding is crucial to detect any potential complications such as hemorrhage or hematoma formation. This includes assessing for unusual bruising, bleeding from the gums, nosebleeds, hematuria, melena, or any other signs of internal or external bleeding. Prompt recognition and management of bleeding complications are essential to ensure patient safety during enoxaparin therapy, especially following orthopedic surgery.

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Correct Answer is B

Explanation

A. Reduced cardiac output: While liver disease can affect circulation in later stages, abnormal coagulation is a more immediate concern.

B. Abnormal coagulation: The liver plays a vital role in producing proteins essential for blood clotting. Liver damage can impair this function, leading to increased bleeding risk.

C. Electrolyte imbalance: The liver plays a role in some aspects of electrolyte balance, but abnormal coagulation is a more specific and critical complication in early liver damage.

D. Respiratory issues: While liver disease can progress to respiratory complications in severe cases, abnormal coagulation is a more immediate threat.

A. Insert a urinary catheter to determine the residual urine B. Hold the next dose of heparin and contact the physician C. Instruct the patient to drink adequate amounts of fluid D. Administer an additional dose of heparin subcutaneously

Correct Answer is B

Explanation

A. Insert a urinary catheter to determine the residual urine. Inserting a urinary catheter may be necessary to accurately measure urinary output and assess for signs of urinary retention. However, the presence of hematuria suggests a potential bleeding complication related to heparin therapy. While monitoring urinary output is important, inserting a urinary catheter should not be the first action taken in response to hematuria. Other interventions to address the bleeding should be prioritized.

B. Hold the next dose of heparin and contact the physician. This is the correct answer. Hematuria can be a sign of a bleeding complication, which is a known side effect of heparin therapy. Holding the next dose of heparin is appropriate to prevent further bleeding, and contacting the physician ensures prompt evaluation and appropriate management of the patient's condition. The physician may decide to adjust the dose of heparin, temporarily discontinue it, or order further investigations to determine the cause of the hematuria.

C. Instruct the patient to drink adequate amounts of fluid. While maintaining hydration is important for overall health, instructing the patient to drink fluids would not directly address the underlying cause of hematuria, which may be related to a bleeding complication from heparin therapy. Holding the next dose of heparin and contacting the physician are more appropriate actions in response to hematuria.

D. Administer an additional dose of heparin subcutaneously. Administering additional heparin would exacerbate the bleeding risk and is contraindicated in the presence of hematuria. It is important to withhold further doses of heparin and seek medical guidance to address the bleeding complication.

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The patient is receiving enoxaparin (Lovenox) subcutaneously every 12 hours following knee replacement surgery. The patient is monitored for.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory report of a client and realizes the liver function tests are elevated, indicating liver damage. The client should be monitored for which potential complication?

Correct Answer is B

Explanation

A patient has been taking heparin for three days and has developed hematuria. The most appropriate action for the nurse is to:

Correct Answer is B

Explanation

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