Casey Hughes

Journal 3
10/24/14
This weeks clinical experience was a very good one for me. For the first time I felt like I
was performing a lot of the basic skills we learned in class independently. I was able to get my
patient up and dressed by myself. I had her dressed and ready and had her vitals taken before
breakfast. It felt good to know I was finally becoming more efficient at these basic skills.
While I was bathing my patient I was able to see the nurse deliver her Lovenox or
enoxaparin shot. It was interesting to see because we have learned so much about anticoagulants
in pharmacology and we had just had our test on these drugs. When I saw that my patient was on
Lovenox in preplanning I knew she was at risk for bleeding. I also knew that the anticoagulant
was mostly administered in the abdomen. My patient had her shot in her abdomen. I also learned
that you have to keep the needle in for a couple seconds to avoid having it bleed. In my patient
anticoagulants are necessary for prevention of DVT and PE. In class we learned that low
molecular weight heparins are used because of the more predictable anticoagulant effects.
Lovenox also has a higher anti factor Xa amount and therefore better bioavailabilty in the body.
Mullaney (2001) stated, In contrast enoxaparin works early in the coagulation cascade
and has limited effect on thrombin. Therefore when this medication is used clinically, traditional
laboratory monitoring of the activated partial thromboplastin time is unnecessary (327).
Enoxaparin is more predictable and therefore easier to monitor in the patient. It is also a more
convenient medication for the patient because it does not have to be administered as often and
its a subcutaneous injection once a day.

Watching the nurse deliver my patients medications was a helpful experience. It always
helps me to watch someone do something in real life so that when I am able to do it I have an
idea of what to do. All of the things I have had an opportunity to see and do in clinical has
enhanced my knowledge of nursing. I know that I will never get a chance to experience
everything in the nursing field but every little experience has helped.
References
Mullaney, S., Letizia, M., & Jennrich, J. (2001). Enoxaparin (Lovenox): An Effective and
Convenient Anticoagulant. MEDSURG Nursing, 10(6), 326.