Bridging Therapy

You know that sometimes the only needed action is to stop the warfarin (Coumadin) several days before the surgery. Other times, the provider initiates “bridging therapy,” or stops the warfarin and provides anticoagulation protection by initiating low-molecular-weight heparin. After reviewing all of his anticoagulation information, the provider decides that Z.N. will need to stop the warfarin (Coumadin) 1 week before the surgery and, in its place, be started on enoxaparin (Lovenox) therapy.

13. Compare the duration of action of warfarin (Coumadin) and enoxaparin (Lovenox), and explain the reason the provider switched to enoxaparin at this time.


Z.N. is in the office and ready for his first enoxaparin (Lovenox) injection

14. Which nursing interventions are appropriate when administering enoxaparin? (Select all that apply.)

a. Monitor activated partial thromboplastin (aPTT) levels.

b. Administer via intramuscular (IM) injection into the deltoid muscle.

c. The preferred site of injection is the lateral abdominal fatty tissue.

d. Massage the area after the injection is given.

e. Hold extra pressure over the site after the injection.

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