Enoxaparin (Lovenox) - LMWH medication templates for care plans PDF

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LMWH medication templates for care plans...

Description

ACTIVE LEARNING TEMPLATE:

Medication

STUDENT NAME _____________________________________

(Lovenox) MEDICATION enoxaparin __________________________________________________________________________ REVIEW MODULE CHAPTER ___________ molecular weight heparin CATEGORY CLASS low ______________________________________________________________________ PURPOSE OF MEDICATION

Expected Pharmacological Action Potentiates the inhibitory effect of antithrombin on factor Xa and thrombin.

Therapeutic Use Prevention of thrombus formation.

Complications edema; alopecia, ecchymoses, pruritus, rash, urticaria; hyperkalemia; constipation, liver enzymes, nausea, vomiting; urinary retention; bleeding, anemia, eosinophilia, thrombocytopenia; erythema at injection site, hematoma, irritation, pain; osteoporosi; dizziness, headache, insomnia; fever

Medication Administration Metabolized in the liver, primarily renally eliminated Clearance SC, IV

Contraindications/Precautions Contraindicated in: Hypersensitivity to enoxaparin, unfractionated heparin, or pork products; Hypersensitivity to benz alcohol (multidose vial);History of immune-mediated heparin-induced thrombocytopenia (HIT) within the past 100 days or in the presence of circulating antibodies; Active, major bleeding. Exercise Extreme Caution in: Severe uncontrolled hypertension; Bacterial endocarditis; Bleeding disorders; GI bleeding/ulceration/pathology; Hemorrhagic stroke; Recent CNS or ophthalmologic surgery; History of thrombocytopenia related to heparin; Spinal/epidural anesthesia or spinal puncture ( risk of spinal/epidural hematom that may lead to long-term or permanent paralysis).

Interactions Risk of bleeding may be increased by concurrent use of drugs that affect platelet function and coagulation, including warfarin, aspirin, thrombolytic agents, NSAIDs, dipyridamole, some penicillins, clopidogrel, abciximab, eptifibatide, tirofiban, and dextran.

Evaluation of Medication Effectiveness Prevention of deep vein thrombosis and pulmonary embolism. Resolution of acute deep vein thrombosis. Prevention of ischemic complications (with aspirin) in patients with unstable angina or non-ST– segment elevation MI. Treatment of acute ST-segment elevation myocardial infarction.

ACTIVE LEARNING TEMPLATES

Nursing Interventions Assess for signs of bleeding and hemorrhage (bleeding gums; nosebleed; unusual bruising; black, tarry stools; hematuria; fall in hematocrit or BP; guaiac-positive stools); bleeding from surgical site. Assess location, duration, intensity, and precipitating factors of anginal pain.Monitor patient for hypersensitivity reactions Observe injection sites for hematomas, ecchymosis, or inflammation.Monitor CBC, platelet count, and stools for occult blood periodically during therapy. If thrombocytopenia occurs, monitor closely. If hematocrit decreases unexpectedly, assess patient for potential bleeding sites. For overdose, protamine sulfate 1 mg for each mg of enoxaparin should be administered by slow IV injection. do not expel the air bubble from prefilled syringes before the injection

Client Education Instruct patient in correct technique for self-injection, care, and disposal of equipment. Advise patient to report any symptoms of unusual bleeding or bruising, dizziness, itching, rash, fever, swelling, or difficulty breathing to health care professional immediately. Instruct patient not to take aspirin, naproxen, or ibuprofen. notify health care professional of therapy before dental or medical treatment or surgery.notify health care professional if pregnancy is planned or suspected or if breastfeeding....