A 78-year-old client weighing 70 kg with a creatinine clearance (CrCl) of 22 mL/min is admitted for treatment of an acute pulmonary embolism. The provider orders enoxaparin 1 mg/kg subcutaneously every 12 hours. Which action by the nurse is most appropriate?

• 1 Increase the dose to 2 mg/kg every 12 hours to compensate for delayed renal elimination.
• 2 Administer the dose as ordered without question; LMWH does not require dose adjustment.
• 3 Switch to oral warfarin at the bedside without provider notification.
• 4 Hold the dose and contact the prescriber to clarify, because severe renal impairment (CrCl ✓ Correct answer

For study reference only. Always follow current clinical guidelines and your institution’s protocols.