Which of the following actions should a nurse plan for when providing care for a client diagnosed with thrombocytopenia?

Avoid needle sticks or other invasive procedures as much as possible.

Hold all stool softeners and laxatives until otherwise

Encourage vigorous tooth brushing with a soft bristle toothbrush,

Obtain a core temperature every 8 hours.

Answer and Explanation

The Correct Answer is A

A. Avoid needle sticks or other invasive procedures as much as possible: This is the most appropriate action for a client with thrombocytopenia. Since thrombocytopenia involves a low platelet count, the risk of bleeding is increased, and minimizing invasive procedures helps prevent complications.

B. Hold all stool softeners and laxatives until otherwise: This statement is not appropriate. Clients with thrombocytopenia should avoid straining during bowel movements, which can be facilitated by the use of stool softeners or laxatives if necessary.

C. Encourage vigorous tooth brushing with a soft bristle toothbrush: This is not advisable. While using a soft-bristled toothbrush is recommended, vigorous brushing could cause gum bleeding. Gentle oral hygiene practices should be emphasized instead.

D. Obtain a core temperature every 8 hours: While monitoring temperature is important, it is not specific to thrombocytopenia management. Other vital signs may be monitored more frequently, but this action does not directly address the primary concern of bleeding risk.

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Correct Answer is D

Explanation

A. Remove the patch if a headache develops: While headaches can be a side effect of clonidine, removing the patch is not the recommended immediate action without further assessment. The patient should be advised to consult with their healthcare provider if they experience significant side effects.

B. Monitor weight on a daily basis: While weight monitoring is important for some medications, it is not a specific recommendation for clonidine. Patients should be informed to monitor for signs of fluid retention or significant weight changes, but daily weight monitoring is not typically required.

C. Place the patch on the anterior chest: The clonidine patch should be placed on a hairless area of skin, typically on the upper arm or chest, but the anterior chest is not specific enough. Patients should be instructed to follow the manufacturer's guidelines for proper placement.

D. Remove the patch as directed and inspect the skin: This is the best discharge instruction. Patients should be informed to remove the patch according to the prescribed schedule and to inspect the skin for any irritation or allergic reactions. Regular skin checks are important to prevent any adverse reactions from prolonged patch use.

A. Furosemide 40 mg PO daily for a client whose blood pressure is 123986. B. Nitroglycerin 0.4 mg SL PRN for a client complaining of chest C. Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats D. Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min

Correct Answer is B

Explanation

A) Furosemide 40 mg PO daily for a client whose blood pressure is 123/86: While furosemide is important for managing fluid status, the client's blood pressure is within a normal range, and this medication does not address any acute concerns.

B) Nitroglycerin 0.4 mg SL PRN for a client complaining of chest pain: This prescription should be implemented first because it addresses an immediate and potentially life-threatening symptom. Chest pain can indicate angina or myocardial infarction, making it critical to relieve this symptom promptly.

C) Metoprolol 25 mg PO bid for a client whose heart rate is 55 beats: While metoprolol is important for managing heart rate and hypertension, a heart rate of 55 beats/minute is on the lower end and could warrant caution. The priority would be to assess the need for medication before administering it.

D) Diltiazem 30 mg PO tid for a client whose heart rate is 90 beats/min: This medication is also important for managing heart rate and hypertension but is not the priority over addressing acute chest pain. The client’s heart rate is within a normal range, so this does not require immediate action compared to the nitroglycerin for chest pain.

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Which of the following actions should a nurse plan for when providing care for a client diagnosed with thrombocytopenia?

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