The nurse provides education to a patient with thrombocytopenia about precautions to be taken at home.
The nurse identifies that further teaching is needed when the patient performs which action?

The correct answer is choice C. Uses an alcohol-based mouthwash twice a day.

Choice A rationale:

Drinking 14 glasses of water daily is generally beneficial as it helps maintain hydration and supports overall health. However, it is important to balance fluid intake to avoid overhydration.

Choice B rationale:

Shaving with an electric razor is recommended for patients with thrombocytopenia because it reduces the risk of cuts and bleeding compared to using a traditional razor.

Choice C rationale:

Using an alcohol-based mouthwash can cause dryness and irritation of the oral mucosa, which can lead to bleeding, especially in patients with thrombocytopenia. It is better to use a non-alcoholic mouthwash.

Choice D rationale:

Brushing teeth with a soft-bristle toothbrush is advised to minimize the risk of gum bleeding and maintain oral hygiene.

The correct answer is Choice D. Then start with Choice A rationale:

Choice A is incorrect because it representsmetabolic alkalosis, not respiratory alkalosis. Metabolic alkalosis occurs when there is a primary increase in the bicarbonate (HCO3) level, which causes the pH to rise above the normal range (7.35-7.45). The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance.Some causes of metabolic alkalosis include vomiting, diuretic use, excessive antacid intake, and mineralocorticoid excess1.

Choice B is incorrect because it representsrespiratory acidosis, not respiratory alkalosis. Respiratory acidosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to fall below the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance.Some causes of respiratory acidosis include hypoventilation, airway obstruction, chest trauma, neuromuscular disorders, and chronic lung diseases2.

Choice C is incorrect because it representsmetabolic acidosis, not respiratory alkalosis. Metabolic acidosis occurs when there is a primary decrease in the HCO3 level, which causes the pH to fall below the normal range. The PaCO2 is normal in this case, indicating that the respiratory system is not involved in the acid-base imbalance.Some causes of metabolic acidosis include diabetic ketoacidosis, lactic acidosis, renal failure, diarrhea, and poisoning3.

Choice D is correct because it representsrespiratory alkalosis. Respiratory alkalosis occurs when there is a primary decrease in the PaCO2 level, which causes the pH to rise above the normal range. The HCO3 is normal in this case, indicating that the metabolic system is not involved in the acid-base imbalance. Some causes of respiratory alkalosis include hyperventilation, anxiety, panic, fever, pain, tumor, trauma, severe anemia, liver disease, overdose of certain medicines, pulmonary embolism, pregnancy, and any lung disease that leads to shortness of breath . Respiratory alkalosis is characterized by symptoms such as breathlessness, dizziness, numbness, tingling, muscle spasms, chest discomfort, confusion, and fainting.