A nurse is caring for 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?

Only use a soft-bristle toothbrush

Apply an ice pack over a bleeding wound

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

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

Answer and Explanation

The Correct Answer is A

A. Only use a soft-bristle toothbrush: Clients with thrombocytopenia are at risk for bleeding, including gum bleeding. Using a soft-bristle toothbrush minimizes trauma to the gums and reduces the risk of bleeding.

B. Apply an ice pack over a bleeding wound: While ice can help constrict blood vessels and reduce minor bleeding, it is not the primary preventative measure for thrombocytopenia-related bleeding.

C. Use a floss pick instead of the floss string to clean between teeth: A floss pick may still cause gum trauma. It is recommended to use a soft flossing technique or avoid flossing if platelet counts are extremely low.

D. Wear sleeveless or short-sleeved shirts and shorts to better visualize any skin issues: While monitoring for petechiae or bruising is important, it does not actively prevent bleeding complications.

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Correct Answer is C

Explanation

A. Dysphagia: Dysphagia (difficulty swallowing) is unrelated to diverticulitis; it is more common in esophageal disorders.

B. Crohn’s disease: Crohn’s disease is a separate chronic inflammatory bowel disease (IBD), not a complication of diverticulitis.

C. Peritonitis: Peritonitis is a life-threatening complication of diverticulitis. If an inflamed diverticulum perforates, stool and bacteria spill into the peritoneal cavity, causing severe abdominal pain, rigidity, fever, and tachycardia.

D. Ulcerative colitis: Ulcerative colitis is another form of IBD, unrelated to diverticulitis.

A. The intestine is twisted around itself causing severe pain B. The child's intestine has a large blockage of scar tissue C. The child's intestine has slipped inside of itself. D. The intestine is missing crucial nerves to aid in peristalsis

Correct Answer is D

Explanation

A. The intestine is twisted around itself causing severe pain: This describes volvulus, a different condition that causes intestinal obstruction and ischemia.

B. The child's intestine has a large blockage of scar tissue: This describes intestinal strictures, which can occur due to Crohn’s disease or previous surgery, not Hirschsprung’s disease.

C. The child's intestine has slipped inside of itself: This describes intussusception, where one part of the intestine telescopes into another, causing obstruction.

D. The intestine is missing crucial nerves to aid in peristalsis: Hirschsprung’s disease is a congenital disorder where the ganglion cells (nerve cells responsible for peristalsis) are absent in parts of the intestine, leading to obstruction and difficulty passing stool.

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A nurse is caring for 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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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