A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues.

Use a floss pick instead of the floss string to floss in between the teeth.

Apply an ice pack over a bleeding wound.

Only use a soft-bristle toothbrush.

Answer and Explanation

The Correct Answer is D

A. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues: While wearing loose or visible clothing may allow skin issues to be seen, it does not directly prevent bleeding complications, and there are more effective measures to focus on.

B. Use a floss pick instead of the floss string to floss in between the teeth: Flossing in any form, especially using a floss pick, can still increase the risk of gum bleeding in thrombocytopenic clients. It is safer to avoid flossing altogether or consult a dentist.

C. Apply an ice pack over a bleeding wound: While applying an ice pack may reduce bleeding once it occurs, it does not prevent bleeding. The focus should be on avoiding activities that increase the risk of bleeding.

D. Only use a soft-bristle toothbrush: Using a soft-bristle toothbrush helps reduce the risk of bleeding from the gums, which is a common issue for clients with thrombocytopenia due to the reduced platelet count.

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Correct Answer is A

Explanation

A. Spider angioma: Spider angiomas are a common manifestation of advanced cirrhosis due to increased estrogen levels resulting from impaired liver function.

B. Increased body hair: Clients with cirrhosis often have decreased body hair due to hormonal imbalances and liver dysfunction, not increased body hair.

C. Weak pulse: While a weak pulse could indicate circulatory issues, it is not a common manifestation specific to cirrhosis. The nurse would expect signs like jaundice, ascites, or edema.

D. Dark-colored stools: Dark-colored stools are more commonly seen in cases of gastrointestinal bleeding or iron supplements. In cirrhosis, the stools are often pale or clay-colored due to bile flow obstruction.

A. Low back pain B. Confusion C. Urinary retention D. Incontinence

Correct Answer is B

Explanation

A. Low back pain: While this can be a symptom of a UTI, it is not unique to older adults and can be seen in various age groups.

B. Confusion: In older adults, UTIs often present with atypical symptoms, such as confusion or delirium, rather than the classic symptoms like dysuria or frequency. This can be a sign of infection in this population.

C. Urinary retention: This is not specific to UTIs in older adults and can occur for other reasons, such as benign prostatic hyperplasia (BPH).

D. Incontinence: Although older adults may experience incontinence, it is not a unique sign of UTI and could be related to other conditions like weakened pelvic muscles.

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A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?

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A nurse is reinforcing teaching with a client who has end-stage liver disease and a recent diagnosis of thrombocytopenia. Which of the following statements provides the best recommendation to prevent complications of bleeding?