lovenox: to hold or not to hold

Virgo_RN, BSN, RN · May 13, 2009

Why does the resident have a catheter? Does he have a history of BPH?

Know that it only takes a small amount of blood (i.e. 1mL) to turn the urine red. That is H&H are WNL means he is not losing a significant amount of blood. The MD has determined that the benefits of this medication outweigh the risks at this point. What I'm wondering is if any urine has been sent to the lab to check for a UTI, or if the resident has any other medical conditions that can cause hematuria, such as kidney stones.

Also, the INR won't be affected by Lovenox. That would be the aPTT.

MoopleRN · May 13, 2009

I have a resident with a hx of dvts which has bleeding in his catheter. We're talking about frank cherry red blood. I've notified doc only to be told to give it anyway. Does lovenox cause hematuria? Can anyone give me places where I can read up about lovenox online?

What's causing the hematuria? That's what I'd be looking into (and that's what you're doing!). You say he has a hx of DVTs, what's his current dx? In my experience, I've never known lovenox to cause hematuria. Is his foley a recent insertion? Was it traumatic? I've seen hematuria in cases like that it and it cleared up in a day or 2. You notified the doctor, s/he said to give it anyway, did you discuss with him/her the possible etiology of the hematuria?

zuzi · May 13, 2009

Points for focus:..report from previous shift

1. HP...why Foley,past renal problems,DVT when at what level, pst Hx of DVt

2. Labs...past labs results, recently

3. Foley...hx.. was changed recently? report from previous shift

4. Meds..lovenox only...how long, many others anticoagulants in the past, call pharmacist

You need to put head to toes all of these and decide by your self, some time YOUR decision is better than any other one, till doctor calls back, or discuss about it with good nurse...choose wise!