1. Self administration teaching Patricia Croteau University of South Florida

2. Behavioral Objectives  State the medical reason for which Fondaparinux is being used (cognitive).  Verbalize the possible side effects associated with the use of Fondaparinux (cognitive).  Verbalize the actions to take in the event a side effect of Fondaparinux should occur (cognitive).  Demonstrate the correct procedure used to administer a Fondaparinux injection with 100% accuracy (psychomotor).

3. Target Audience  Any patient that has a history of: deep vein thrombosis pulmonary embolism  Any patient that is at increased risk for developing: deep vein thromobis pulmonary embolism * Note: Examples of patients at increased risk are any patients that have had knee replacement, hip replacement, hip surgery or abdominal surgery

4. Environment for Learning  Patient teaching may take place In a classroom Some facilities conduct group teaching in a classroom for patients that are having scheduled surgeries. Physician’s office Some Orthopedic surgeons have their nurses conduct teaching to their patients in the office once the patient has scheduled their surgery. Patient bedside For patients in the hospital, most of these patients had emergency surgery so there was no time before the surgery for teaching to take place.

5. What is Fondaparinux?  Fondaparinux (Arixtra) is a blood thinner, also known as an anticoagulant. ("Gsk source," 2011)

6. Why do I need Fondaparinux? o Fondaparinux helps to prevent blood clots from forming in patients who have had surgery of the hip, knee, or the stomach area (abdominal surgery). o Fondaparinx is also used to treat patients who have blood clots in their legs (Deep Vein Thrombosis, DVT) or blood clots that travel to their lungs (Pulmonary Embolism, PE). ("Gsk source," 2011)

7. DVT and PE

8. What are some of the side effects that might occur?  Severe bleeding  Allergic reaction  Reaction at site of injections  Anemia (low red blood cell count)  Increased liver enzyme results  Insomnia ("Gsk source," 2011)

9. What should I do if I have a side effect? o Call your doctor o Call 911 OR

10. How to administer Fondaparinux  Gather all necessary supplies: Pre-filled medication syringe Alcohol wipes Gloves

11. How to administer Fondaparinux  Wash your hands with soap & water

12. How to administer Fondaparinux  Choose site for injection The spot should be on your lower stomach area (abdomen), approx. 2 inches below your belly button. It is important to change sides (left/right) for each injection.  Cleanse site with alcohol wipe

13. How to administer Fondaparinux Between your thumb and forefinger, gently pinch the skin at injection site. Insert the needle at a 90 angle. Push syringe plunger down as far as it will go. As you release the plunger the needle will be pulled up into the safety sleeve. Note: to decrease chances of bruising do not rub site after injection

14. How to administer Fondaparinux  Properly dispose of syringe in approved sharps container

15. CREDITS: PHOTOS:  Slide 1: http://medconnections.com/drugs/images/full/arixtra-4.jpg  Slide 7: http://www.effectivehealthcare.ahrq.gov/ehc/assets/Image/vteconsimage2.png  Slide 9 Image 1: http://1.imimg.com/data/K/L/MY-1488601/doctor-on- call_10929741_250x250.jpg Image 2: http://www.hall- markfire.com/florida/images/aa_hillsborough_county_EMS_sm.jpg  Slide 10 Image 1: http://medconnections.com/drugs/images/full/arixtra-4.jpg Image 2: Photo taken by Patricia Croteau 2012, October 11  Slide 11: Photo taken by Patricia Croteau 2012, October 11  Slide 12: http://3.bp.blogspot.com/_vWjkYJfw- iw/StPGOVc8ibI/AAAAAAAACGk/2u2MieBDdrI/s400/Male+Torso+-+Skin+textured+- +From+Jaguar+model_640x480.JPG  Slide 13: http://www.gsksource.com/gskprm/en/US/adirect/gskprm?cmd=ProductDetailPage&product_id =1244136744215&featureKey=600552#section-42230-3  Slide 14: http://www.lbl.gov/ehs/waste/images/pub-3095/image019.jpg

16. References: Gsk source. (2011). Retrieved from http://www.gsksource.com/gskprm/en/US/adirect/gskp rm?cmd=ProductDetailPage&product_id=12441367442 15&featureKey=600552