A nurse is caring for a patient with thrombocytopenia.
The patient reports experiencing hematochezia, fatigue, and abdominal pain.
What should the nurse prioritize in the assessment of this patient?

Choice A rationale:

Administering alternative anticoagulants.

Administering alternative anticoagulants is not the primary intervention for preventing or managing bleeding in a client with thrombocytopenia.

Anticoagulants may increase the risk of bleeding in such patients and are generally not indicated unless there is a specific medical reason to use them.

Choice B rationale:

Preparing the client for splenectomy.

Splenectomy is not typically performed as a preventive measure for bleeding in thrombocytopenic patients.

While splenectomy may be considered in some cases of immune thrombocytopenia, it is not the essential nursing intervention to prevent or manage bleeding in most clients with thrombocytopenia.

Choice C rationale:

Avoiding platelet transfusions.

Avoiding platelet transfusions is not a recommended intervention in clients with thrombocytopenia who are at risk of bleeding complications.

Platelet transfusions are often necessary to raise platelet levels and prevent or manage bleeding in these individuals.

Choice D rationale:

Applying pressure to any bleeding site and elevating the affected area.

This is the essential nursing intervention to prevent and manage bleeding in clients with thrombocytopenia.

Applying pressure to a bleeding site helps control bleeding, and elevating the affected area can reduce swelling and minimize bleeding.

It is a fundamental measure in the care of thrombocytopenic clients.

Choice A rationale:

Encourage the patient to consume NSAIDs for pain relief.

Encouraging the use of NSAIDs for pain relief is not appropriate for patients with thrombocytopenia.

NSAIDs can further increase the risk of bleeding due to their antiplatelet effects.

Therefore, it is crucial to educate patients to avoid NSAIDs.

Choice B rationale:

Teach the patient to avoid alcohol and aspirin.

This is a crucial part of patient education for those with thrombocytopenia.

Alcohol and aspirin can both increase the risk of bleeding, so advising patients to avoid them is essential to minimize bleeding risks.

Choice C rationale:

Suggest regular injections to stimulate platelet production.

While there are treatments available to stimulate platelet production, they are typically prescribed by a healthcare provider based on the patient's specific diagnosis and medical needs.

Suggesting regular injections without medical guidance is not appropriate.

Choice D rationale:

Advise the patient to skip monitoring platelet counts.

Regular monitoring of platelet counts is essential for patients with thrombocytopenia to assess the effectiveness of treatment and identify any potential complications.

Advising the patient to skip monitoring is not appropriate and may lead to undetected issues.