Which nursing measures are important for a patient with thrombocytopenia?

• A. Administer IM injections as needed to monitor bleeding.
• B. Bleeding precautions, avoid IM injections and unnecessary venipunctures, use a soft toothbrush, monitor for signs of bleeding, and transfuse platelets per orders.
• C. Use a hard toothbrush and frequent venipunctures to check platelets.
• D. Avoid all bleeding precautions to promote healing.

Answer: (B)

Thrombocytopenia heightens bleeding risk, so nursing care focuses on preventing bleeding and recognizing signs early. The important measures include bleeding precautions: minimize invasive procedures by avoiding intramuscular injections and unnecessary venipunctures; if a venipuncture is needed, use gentle technique and apply pressure for an extended time afterward. Use a soft toothbrush and avoid aggressive dental brushing or mucosal trauma. Monitor for signs of bleeding, such as new petechiae, easy bruising, gum bleeding, nosebleeds, blood in stool or urine, or any unusual changes in vital signs that might indicate bleeding. Platelet transfusions are given per orders when the count is very low or if there is active bleeding or before invasive procedures. Also limit NSAIDs or anticoagulants and use protective measures (electric razor, no rectal temps) to reduce bleeding risk. This combination best addresses the needs of a patient with thrombocytopenia.