Page 1768 - Saunders Comprehensive Review For NCLEX-RN

to prevent bleeding.

e. The antidote to heparin is

protamine sulfate.
f. When administering heparin
subcutaneously, inject into the
abdomen with a ⅝-inch (16-mm)
needle (25 to 28 gauge) at a 90-degree
angle and do not aspirate or rub the
injection site.

g. Continuous IV infusions must

be run on an infusion pump to ensure
a precise rate of delivery.
D. Enoxaparin or Rivaroxaban—low-molecular-weight heparins
1. Description: Enoxaparin and rivaroxaban have the
same mechanism of action and use as heparin but are
not interchangeable with heparin; they have longer
half-lives than heparin does.
2. Interventions

a. Administer enoxaparin only to

the recumbent client by subcutaneous
injection into the anterolateral or
posterolateral abdominal wall; do not
expel the air bubble from the prefilled
syringe or aspirate during injection.
b. Rivaroxaban is a taken orally, once
daily.
c. Monitor results of the Anti-Xa assay.
The therapeutic range for
anticoagulation is 0.5 to 1.2 IU/mL
(conventional and SI units). Observe
for bleeding.

d. The antidote to low-molecular-

weight heparins is protamine sulfate.
E. Warfarin sodium
1. Description
a. Warfarin suppresses coagulation by
acting as an antagonist of vitamin K by
inhibiting 4 dependent clotting factors
(X, IX, VII, and II).
b. Warfarin prolongs clotting time and is
monitored by the prothrombin time
(PT) and the international normalized
ratio (INR).

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