The nurse is providing care to a patient who has just undergone a procedure in which epidural anesthesia was used

Question

When the patient returned from the procedure, the nurse administered enoxaparin (Lovenox) 30 mg as ordered. Which of the following findings would warrant an immediate call to the prescriber if it occurred after enoxaparin administration?
a. The patient's pulse oximetry reading decreases from 99% to 96%.
b. The patient complains of pain at the enoxaparin injection site.
c. The patient complains of numbness and tingling in the lower extremities.
d. The right dorsalis pedis pulse is +3, and the left dorsalis pedis pulse is +2.

Answer 1

ANS: C
LMW heparins can cause severe neurologic injury, including permanent paralysis, when given to a patient undergoing spinal or epidural anesthesia. Neurologic injury results from pressure on the spinal cord generated by epidural or spinal bleeding. Numbness and tingling in the lower extremities can be a sign a sign of this condition.
Although the patient's oxygen saturation is slightly decreased, it is still within normal limits.
Pain at the injection site can occur and does not warrant an immediate call to the prescriber.
A pulse of +2 is palpable, and a pulse of +3 is strong and easily palpable. Both findings are normal. No information indicates that the patient's pulse strength has changed.