ENOXAPARIN (Lovenox) is a low-molecular-weight heparin commonly used to prevent or treat acute deep vein thrombosis. A patient taking enoxaparin is at risk for bleeding, including retroperitoneal and intracranial bleeding, so monitor her carefully.
* Evaluate the patient for any contraindications to drug therapy and for conditions, medications, and procedures that increase her risk of hemorrhage.
* Confirm the order. Check the patient's most recent lab results, including her complete blood cell and platelet count. Check her medication administration record for previous dose and site.
* Perform hand hygiene. Prepare the medication and identify the patient according to your facility's guidelines.
* Provide privacy and explain the procedure to her. Place her in a supine position.
* Pull the needle shield straight off the safety syringe. Don't expel the air bubble.
* Ask the patient to relax and take a deep breath. Tell her that she may feel some burning.
* Pull the needle straight out, then release the skin fold. While orienting the needle downward away from yourself and others, activate the syringe safety system by firmly pushing the plunger rod. Immediately dispose of the syringe in the nearest sharps container.
* If needed, use dry gauze to apply gentle pressure to the site until bleeding stops. Remove your gloves and perform hand hygiene.
* Document the time, dose, site, and patient response to the injection.
* Instruct the patient not to rub the injection site and to report any bleeding, bruising, or pain. Tell her that bleeding may take longer than usual to stop.
* During therapy, monitor the patient for signs and symptoms of overt or occult bleeding.
* If she'll continue taking enoxaparin after discharge, teach her to inform physicians and dentists that she's taking enoxaparin.
* Don't administer enoxaparin I.M.
* Don't use the drug if it's discolored or contains visible particulate matter.
* Don't aspirate the needle during administration.
* Don't use enoxaparin interchangeably with heparin or other low-molecular-weight heparins.
Best D, Grainger P. Treating acute coronary syndromes with enoxaparin. Nursing2004. 34(5):32cc1-32cc2, May 2004.
Frequently asked questions. Low molecular weight heparins. http://www.aahcp.org/dvt/faqs.htm. Accessed July 23, 2007.
How to continue your Lovenox treatment at home. http://www.lovenox.com/docs/pdf/LovenoxAtHomeBrochure.pdf. Accessed January 4, 2008.
Lovenox (enoxaparin sodium injection). http://www.products.sanofi-aventis.us/lovenoxlovenox.html. Accessed July 23, 2007.