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 B

Explanation

peritonitis are present. Treating the underlying cause (perforation) is more urgent than lowering the fever.

B. Notify the healthcare provider: A hard, rigid abdomen with fever indicates possible perforation and peritonitis, which is a medical emergency. The provider must be notified immediately for urgent intervention.

C. Prepare to administer an enema: Enemas are contraindicated in acute diverticulitis due to the risk of perforation.

D. Continue to monitor the client closely: While continued monitoring is always necessary, immediate action (calling the provider) is critical when signs of peritonitis are present.

A. "Take pain relief medication such as acetaminophen to relieve discomfort associated with ascites.” B. "Avoid high-sodium foods such as canned soups/vegetables, processed meats and prepackaged from diners C. "Ensure that you sat three large meals per day to keep your calories up." D. “Increase your activity as much as possible. You need to remain active.”

Correct Answer is B

Explanation

A. "Take pain relief medication such as acetaminophen to relieve discomfort associated with ascites." Acetaminophen is hepatotoxic and should be avoided in clients with liver disease.

B. "Avoid high-sodium foods such as canned soups/vegetables, processed meats, and prepackaged foods." Sodium restriction helps prevent fluid retention and ascites in clients with cirrhosis. Processed and canned foods are high in sodium and should be avoided.

C. "Ensure that you eat three large meals per day to keep your calories up." Clients with cirrhosis should eat small, frequent meals to avoid hypoglycemia and excessive strain on the liver.

D. "Increase your activity as much as possible. You need to remain active." While moderate activity is encouraged, clients with cirrhosis often have fatigue and muscle wasting. Overexertion can worsen their condition.

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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

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