A nurse is preparing to administer enoxaparin sodium (Lovenox) to a client for prevention of deep vein thrombosis. What is an essential nursing intervention?

• A. Draw up the medication in a syringe with a 22-gauge, 1-½ inch needle.
• B. Utilize the Z-track method to inject the medication.
• C. Administer the medication into subcutaneous tissue.
• D. Rub the administration site after injecting.

Answer: (C)

Giving enoxaparin by subcutaneous injection is the essential nursing intervention. Enoxaparin is a low-molecular-weight heparin used for DVT prophylaxis and is intended for subcutaneous administration to achieve predictable anticoagulant effects with a lower risk of bleeding compared with intramuscular injections. The Z-track method is used for intramuscular injections and is not appropriate for subcutaneous dosing. Rubbing the injection site after administration can cause more bleeding or bruising, which is especially undesirable with anticoagulants. So the key concept is ensuring the medication is delivered into subcutaneous tissue to provide safe, effective prevention of thrombosis.