New orders lovenox dvt prevention

[uniquegifts1]

So I had a patient who had a positive dvt in her brachial arm and I had given already 30mg of subq w lovenox at 6am. The doc put in new order about an hour later to administer 60mg of lovenox now which was 7:15am and then later in the day. I gave the second dose, in hindsight, should I have called and inform him of the one already given? He has access to the med Rec and I assumed this was apart of the therapeutic loading dose for her DVT management.

[jadelpn, LPN, EMT-B]

Not medical advice per TOS, however, dosing is based on KG. I would always be sure that the MD realizes that a dose had been given already. However, for informational purposes only, and it could be vastly different in other facilities and with other protocols, a 30 mg would be for somewhere around a 64 pound person. Add a 60mg dose and the total given would be 90mg or for around an 184 pound person. So be sure that the evening dose (usually 12 hours later) is 90mg. If it is not, and again if the dose is too high for the kg of your patient, call to clarify what dose the patient should be on.

[uniquegifts1]

She was on 30mg just I think for prevention on DVT prior to ultrasound of her arm after the results he changed to 60mg sub q bid for maintenance of dvt.

[ParvulusPuella]

I would have called, to ask if he wanted the new dose added to the first (so total of 90mg) or enter another order for a 1 time of an additional 30mg (to equal the 60mg).