A nurse is preparing to administer enoxaparin (Lovenox) to a client who has a pulmonary embolism.
Which of the following actions should the nurse take?
A.
Inject the medication into the deltoid muscle.
B.
Expel the air bubble from the prefilled syringe.
C.
Pinch the skin at the injection site.
D.
Apply pressure to the injection site after administration.
The Correct Answer and Explanation is:
The correct answer is C. Pinch the skin at the injection site.
Explanation:
Enoxaparin (Lovenox) is a low molecular weight heparin used as an anticoagulant to prevent and treat thromboembolic disorders, such as pulmonary embolism. It is administered subcutaneously, commonly in the abdomen. Proper technique is crucial to ensure the medication’s effectiveness and minimize discomfort or complications. Here’s a breakdown of why option C is the correct choice and why the other options are not appropriate:
- Pinch the skin at the injection site (Option C): This action is recommended when administering enoxaparin subcutaneously. Pinching the skin creates a fold that helps to lift the subcutaneous tissue away from the muscle, ensuring that the medication is injected into the correct layer. This technique helps prevent the medication from being injected into the muscle and minimizes the risk of bruising and bleeding. It also helps ensure that the full dose of medication is delivered into the subcutaneous tissue.
- Inject the medication into the deltoid muscle (Option A): Enoxaparin should not be injected into the deltoid muscle or any muscle; it must be administered subcutaneously. Injecting into the muscle could lead to complications such as hematoma formation or ineffective medication delivery. Subcutaneous administration in the abdomen (except the area around the navel) is preferred for optimal absorption.
- Expel the air bubble from the prefilled syringe (Option B): For enoxaparin, it is generally advised to leave the air bubble in the syringe. This bubble helps ensure that the entire dose of medication is delivered and reduces the risk of leakage. Expelling the air bubble can increase the risk of dosage error and potentially affect the drug’s efficacy.
- Apply pressure to the injection site after administration (Option D): Applying pressure to the injection site immediately after administration is not recommended. Instead, it may cause bruising and discomfort. However, gentle pressure can be applied if there is bleeding or oozing, but it should not be a routine practice following enoxaparin injections.
In summary, pinching the skin at the injection site ensures proper subcutaneous administration of enoxaparin, reducing the risk of complications and ensuring effective drug delivery.