A patient who is obese is preparing to have surgery. To help prevent venous thromboembolism (VTE), the primary care NP should prescribe:
a. low-dose aspirin once daily.
b. clopidogrel (Plavix) 75 mg once daily.
c. enoxaparin (Lovenox) 30 mg twice daily.
d. warfarin (Coumadin) titrated to achieve an INR of 3.5.
C
The American College of Clinical Pharmacy recommends against the use of aspirin alone for prophylaxis of VTE. Patients undergoing surgery who are at moderate to high risk for VTE should receive unfractionated heparin or low-molecular-weight heparin, such as enoxaparin. Aspirin may be part of the prophylaxis regimen. Clopidogrel and warfarin are not recommended.
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