lovenox one dose??? huh??

[ohmeowzer RN]

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...

[pagandeva2000, LPN]

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.

:up:I second that. I like to know what doctors make certain decisions in case I come across a similar situation in the future. Most of the attendings I work with also LOVE when people ask them questions...in fact, some of them have brought me literature weeks afterwards for me to keep.

[BradleyRN]

One dose of Lovenox is definitely several doses short of the prophylactic intent of the prescription, unless she was going home the next day. If the doctor was humoring you, i dont know why he wouldnt use Fragmin instead, since it is much cheaper. Does the pt have TED hose and SCD's? A doctor may fear giving LMWH with a history of bleeding, but should be happy to write an order for these.

[Texas Tornado]

I agree w/ BradleyRN. SCD's would be a safe alternative.