The client with a joint replacement is scheduled to receive Lovenox (enoxaparin). Which lab value should be reported to the doctor? A. PT of 20 seconds B. PTT of 300 seconds C. Protime of 30 seconds D. INR 3

Lovenox (enoxaparin) is an anticoagulant, which means it prevents blood clots from forming. It works by inhibiting the formation of fibrin, which is necessary for blood clotting. This medication is often prescribed to patients after joint replacement surgery to reduce the risk of developing deep vein thrombosis (DVT) or other blood clots.

A. PT (Prothrombin Time): This measures the time it takes for a clot to form in a blood sample. It assesses the extrinsic pathway of the coagulation cascade. An increased PT means that it takes longer for blood to clot, which could indicate the effectiveness of an anticoagulant. B. PTT (Partial Thromboplastin Time): This test measures the time it takes for a blood clot to form in a blood sample, assessing the intrinsic pathway of the coagulation cascade. Similar to PT, an increased PTT implies that it takes longer for the blood to clot. C. Protime: This is another term for PT. D. INR (International Normalized Ratio): This is a standardized way of expressing PT results, which allows for consistency across different laboratories. A higher INR indicates that it takes longer for the blood to clot. An INR around 2-3 is typically the target range for patients on anticoagulant therapy.

Given that Lovenox (enoxaparin) is an anticoagulant, we need to report the lab value that demonstrates its effect on blood clotting. In this case, since enoxaparin has a more significant effect on the intrinsic pathway of the coagulation cascade, PTT (B) would be the most important lab value to report. PTT of 300 seconds is significantly prolonged and should be reported to the doctor, as it may indicate an increased risk of bleeding or require an adjustment to the patient's Lovenox dosage.