In a patient with thrombocytopenia due to AML, which action is contraindicated?

• A. Observe for melena and hematuria
• B. Brush and floss at least twice daily
• C. Measure abdominal girth daily
• D. Apply ice and pressure to puncture sites

Answer: (B)

In thrombocytopenia, the risk of bleeding is high because there are too few platelets to form clots cleanly. Any trauma to mucous membranes can trigger bleeding more easily. Brushing and flossing at least twice daily can injure gum tissue and mucosa, making it contraindicated in this setting. By contrast, watching for signs of bleeding like melena or hematuria helps detect occult bleeding, measuring abdominal girth daily monitors for changes in the abdomen, and applying ice and pressure to puncture sites helps control bleeding if minor injuries occur. So the action that should be avoided is aggressive dental hygiene that can injure mucosal tissue.