A nurse is caring for a client following a total knee replacement. Which of the following medications should the nurse anticipate the provider will prescribe to prevent the formulation of a deep vein thrombosis (DVT)?
Explanation & Rationale
Choice A reason: Aspirin may be used for DVT prophylaxis in low-risk cases, but it is less effective than anticoagulants like enoxaparin after major orthopedic surgery. Total knee replacement carries a high DVT risk, requiring stronger prophylaxis, making aspirin a less preferred choice for this scenario. Choice B reason: Warfarin is an anticoagulant but requires days to reach therapeutic levels, making it less ideal for immediate postoperative DVT prevention. Enoxaparin acts quickly, providing effective prophylaxis after knee replacement, making warfarin less suitable and incorrect for this context. Choice C reason: Enoxaparin, a low-molecular-weight heparin, is commonly prescribed post-total knee replacement to prevent DVT. It inhibits clot formation by enhancing antithrombin activity, offering rapid, effective prophylaxis, aligning with guidelines for high-risk orthopedic surgeries, making this the correct choice. Choice D reason: Alteplase, a thrombolytic, dissolves existing clots but is not used for DVT prevention. It increases bleeding risk, inappropriate for routine postoperative prophylaxis, making this choice incorrect compared to enoxaparin’s preventive mechanism.