CEA Nursing Practice Exam

What should a patient expect regarding the administration of enoxaparin when starting warfarin therapy?

1. Enoxaparin is unnecessary when starting warfarin

2. Enoxaparin is only needed for 1 day

3. Enoxaparin will be used until INR is over 2.0

4. Enoxaparin should be taken indefinitely

The correct answer is: Enoxaparin will be used until INR is over 2.0

When starting warfarin therapy, it is common practice to continue the use of enoxaparin for a period until the International Normalized Ratio (INR) reaches a therapeutic level, typically above 2.0. This is done to ensure that the patient is adequately anticoagulated, as warfarin takes several days to exert its full anticoagulant effect. Enoxaparin provides immediate anticoagulation, allowing for a safe transition to warfarin, which prevents thromboembolic events during the period when the INR is still low. The other options do not reflect the clinical guidelines for initiating warfarin therapy. While enoxaparin is essential in bridging therapy, to suggest it is unnecessary, only needed for 1 day, or to be taken indefinitely does not align with accepted medical practices. Thus, using enoxaparin until the INR is effectively therapeutically managed is the standard approach, ensuring patient safety during the transition to long-term anticoagulation with warfarin.