A client receiving therapeutic-dose enoxaparin as perioperat… | MyMerci
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Medication Administration PPT
Question

A client receiving therapeutic-dose enoxaparin as perioperative bridging is scheduled for surgery Tuesday at 0800. Which statement by the client shows correct understanding of the preoperative plan?

Explanation
For therapeutic-dose low-molecular-weight heparin bridging, the last preoperative dose is generally scheduled about 24 hours before surgery. The postoperative restart depends on procedural bleeding risk and the written prescriber plan.
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In-depth explanation

Quick answer
The teach-back should match the written plan: last therapeutic enoxaparin dose about 24 hours before surgery.

Why this is correct
Therapeutic-dose LMWH given too close to surgery leaves clinically important anticoagulant activity and increases bleeding risk. Restart timing is individualized to hemostasis and procedural bleeding risk.

Easy analogy or mental picture
Create a protected gap around the procedure, then reopen anticoagulation only when the surgical team confirms it is safe.

Memory hook
Therapeutic LMWH: think 24 hours before.

NCLEX decision rule
Use the ordered perioperative schedule, dose intensity, renal function, and bleeding risk; never improvise a hold or restart.

Why the other choices are wrong
A day-of-surgery dose is too close, a 7-day hold creates an unnecessary gap, and visible bleeding is not the criterion for continuing anticoagulation through surgery.
References
1CHEST: Perioperative Management of Antithrombotic TherapyTiming of the last therapeutic LMWH bridging dose
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For study reference only. Always follow current clinical guidelines and your institution’s protocols.