A patient with a venous thromboembolism (VTE) is started on enoxaparin (Lovenox) and warfarin (Coumadin). The patient asks the nurse why two medications are necessary. Which response by the nurse is accurate?

Rationale: A. Enoxaparin, a low molecular weight heparin, provides immediate anticoagulation by inhibiting factor Xa. Warfarin works by inhibiting vitamin K–dependent clotting factors but takes 3–5 days to reach therapeutic effect, so both drugs are overlapped until warfarin is effective. B. Neither enoxaparin nor warfarin dissolves an existing clot; instead, they prevent clot propagation and new clot formation. Clot resolution occurs naturally through the body’s fibrinolytic system. C. The dual therapy is not used because of clot location risk, but rather because of the pharmacokinetics of the two medications. The overlap ensures continuous anticoagulation until warfarin becomes therapeutic. D. Using two anticoagulants together does not provide additive long-term protection. The overlap is temporary, serving to maintain anticoagulation until warfarin reaches therapeutic levels, after which enoxaparin is discontinued.