What is the appropriate action for a nurse caring for a client on enoxaparin if their aPTT is significantly elevated?

Administering protamine sulfate is the appropriate action for a nurse caring for a client on enoxaparin when the activated partial thromboplastin time (aPTT) is significantly elevated. Enoxaparin is a low molecular weight heparin that can affect clotting times, and a significantly elevated aPTT indicates a potential increased risk for bleeding.

Protamine sulfate is an antidote that neutralizes the anticoagulant effects of heparin and low molecular weight heparins like enoxaparin. By administering protamine sulfate, the nurse is actively working to reverse the anticoagulation effects, thus reducing the risk of adverse bleeding complications. This action is critical to maintaining the safety and health of the client.

Increasing the enoxaparin dose would likely exacerbate the problem by further prolonging the aPTT and increasing the risk of bleeding. Continuing with the scheduled dose fails to address the elevated aPTT and places the client at risk. Typing and cross-matching for blood transfusion is not a direct management strategy for elevated aPTT but is more relevant if there were significant bleeding requirements already established. Therefore, administering protamine sulfate is the most clinically appropriate response in this scenario.