A nurse is preparing to administer enoxaparin sodium (Lovenox) subcutaneously to a client. Which of the following is an appropriate action by the nurse?

Choice A rationale Enoxaparin sodium is a low molecular weight heparin (LMWH) that is administered subcutaneously, preferably into the anterolateral or posterolateral abdominal wall. Injection should be given at least two inches away from the umbilicus, surgical scars, and other lesions to ensure good absorption and minimize hematoma risk. This site has ample subcutaneous tissue for absorption. Choice B rationale Massaging the injection site following the administration of enoxaparin is contraindicated. The mechanical action of massage can increase the risk of bruising and hematoma formation at the injection site due to its anticoagulant properties, as it can disrupt local blood vessels and increase drug dispersion. Choice C rationale Subcutaneous injections typically utilize a shorter needle, often 5/8 inch, to deposit the medication into the subcutaneous tissue layer. A 1-inch needle is typically used for intramuscular (IM) injections, which would deliver the enoxaparin too deeply, potentially causing unnecessary discomfort and poor absorption. Choice D rationale Subcutaneous injections are typically administered with a 25-gauge or 27-gauge needle to minimize tissue trauma and pain. A 22-gauge needle is larger (has a wider lumen) and is typically used for thicker intramuscular injections or intravenous access, making it inappropriate for the intended subcutaneous route.