lovenox one dose??? huh??

Nurses General Nursing

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Specializes in ob/gyn med /surg.

i am perplexed... i had a dr order one dose of lovenox 40mg sq for a patient.. she's an older lady with general weakness .. she did have a history of lady partsl bleeding...

well , the doc came in and i explained to him i was worried about the pt developing a dvt ... he said " okay we'll just give her one dose of lovenox and that should be fine" she's bee in the hospital for 3 weeks laying in bed..

i realize she has a history of lady partsl bleeding.. but what can 1 dose of lovenox do? i wouldn't think it would do anything to her... do you? i saw no lady partsl bleeding after that 1 dose ... but would you ?

dosen't lovenox work over a peroid of days? i thought it took time to build up ... i didn't think one dose of lovenox would thin a flea's blood??

seemed like a waste of time sticking her... :banghead:

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Specializes in Cardiac Telemetry, ED.

No, Lovenox is a low molecular weight heparin. It acts rapidly and has a relatively short half life. It sounds like the doc was just humoring you. Has the doc been monitoring her APTT or INR?

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Specializes in ob/gyn med /surg.
No, Lovenox is a low molecular weight heparin. It acts rapidly and has a relatively short half life. It sounds like the doc was just humoring you. Has the doc been monitoring her APTT or INR?

i guess he was humoring me.. i guess the lovenox didn't stay in her system to long then?? no he didn't order a PTT or an INR or anything... i wish he would of just expalined to me what he was thinking...

do you think he ordered just one dose because he thought i was .. well dumb .. or maybe I just worried for nothing and tried to just shut me up? when he knew it would act quick and be gone in her system? how long do you think it lasted in her system?? so it just came and went in her system and poof gone?

the doc must think i'm a overzleous nurse and just ordered it once , maybe knowing it wouldn't do much ... gosh i feel foolish...

do you think i gave her the shot for nothing?? i hate sticking people for no reason... maybe it worked for a few minutes...

ooh welll ...:banghead:

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Specializes in Cardiac Telemetry, ED.

No, I don't think you gave it for nothing. DVT is serious business and you have reason to be concerned. Try asking the physician about their thinking sometime. Some docs like to teach.

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Specializes in ob/gyn med /surg.
No, I don't think you gave it for nothing. DVT is serious business and you have reason to be concerned. Try asking the physician about their thinking sometime. Some docs like to teach.

well , i was worried about the lady.. my intentions were good..

the doc is kinds hard to approach and he talks so fast , but next time i will just ask him to explain to me his reasoning... at least i will ask...

i know he was worried about her lady partsl bleeding history .. there was no lady partsl bleeding after i gave ny one dose..lol..

thank you for making me feel better... i knew there was something fishy about that order.. one dose ?? now i am wiser ...

i send you llots of hugs:heartbeat

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Specializes in Cardiac Telemetry, ED.

Well, I don't feel I deserve the hugs, but I'll take them anyway!

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Specializes in Cardiothoracic Transplant Telemetry.

As long as the dosing was correct she would have been protected for 12 hours, so one way to look at it is that she was protected from making more clots on your shift! Thank you for looking out for your patient!

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Specializes in Ortho, Case Management, blabla.

Was she on any other sort of DVT prophylaxis (ie aspirin/coumadin/plavix)? Sometimes the docs will order a dose or two of lovenox as short term coverage until the other drugs get a chance to kick in.

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Specializes in CNA, Surgical, Pediatrics, SDS, ER.

We just had a pt this w/e that had a PE and had a dose of lovenox and no heparin was ordered, the nurse questioned if heparin needed to be started but the ER doc and the attending did not order it. Has anyone ever heard of that before? I don't know if it got ordered at a later time on the floor but why wouldn't you start heparing for a PE right away?

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Specializes in CCU & CTICU.
We just had a pt this w/e that had a PE and had a dose of lovenox and no heparin was ordered, the nurse questioned if heparin needed to be started but the ER doc and the attending did not order it. Has anyone ever heard of that before? I don't know if it got ordered at a later time on the floor but why wouldn't you start heparing for a PE right away?

I've had md's tell me they prefer Lovenox to Heparin b/c it is easier and faster to get to the therapeutic range. But even if they prefered Lovenox, they always made it a standing order, until the pt was switched over to Coumadin. Pt should get it at least once a day, if they're not getting anything else.

Maybe it was only one dose b/c they were planning to take the pt for a Greenfield filter or some other procedure the next day?

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Specializes in CNA, Surgical, Pediatrics, SDS, ER.

When we were discussing it amongst ourselves yesterday we thought that lovenox took longer to get into your system than heparin IV.

Thanks for the info.

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Actually, the latest tx for PE is lovenox. We've had several pt's doing just lovenox, can't remember for how long. then of course someone came in the they ordered heparin drip, He had a ton of complications, was in for like 2 weeks. Hard to change but fewer complications w/lovenox

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