The nurse reviews a fondaparinux prescription for postoperative venous-thromboembolism prophylaxis. Which findings require clarification or immediate follow-up? Select exactly 4 responses.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Fondaparinux prophylaxis is contraindicated with creatinine clearance below 30 mL/min, adult body weight below 50 kg, or active major bleeding. Postoperative prophylaxis begins only after hemostasis and no earlier than 6 to 8 hours after surgery.
Quick answer Check kidney function, body weight, active bleeding, and postoperative timing.
Why this is correct Fondaparinux is eliminated unchanged by the kidneys and can produce prolonged anticoagulation with renal impairment. Low body weight and dosing before hemostasis increase major bleeding risk.
Easy analogy or mental picture Build a medication safety chain: identify the cue cluster, connect it to the drug mechanism, stop preventable exposure, stabilize the client, and verify the response with measurable findings.
NCLEX decision rule Choose the action that prevents the most immediate medication-related harm while preserving treatment for the underlying condition.
Why the other choices are wrong Options that rely on one reassuring value, continue a suspect exposure, bypass monitoring, or delay escalation leave the medication hazard active.