Question

a client has a low platelet count, which is important to teach the client?

2. The nurse is assessing a client who is immobile and notices a red area over the client's coccyx. Which of the following actions should the nurse take?

Answer 1

Client education for a patient with low platelet count

The following health teachings should be given to a client with a low platelet count:

• Keep the mouth clean and dry.
• Brush teeth gently with a soft-bristle toothbrush.
• Do not use dental floss.
• Avoid any commercial product containing alcohol; as alcohol can dry the mouth and lead to bleeding.
• Use lip balm or petroleum jelly on the lip to prevent cracking of lips.
• If the client has a cough, he/she should not cough forcefully.
• Do not blow nose too hard.
• Do not use rectal thermometers, suppositories, etc
• Avoid straining during bowel movements, if the client has constipation then inform the physician.
• Use electric razors for shaving.
• Do not take any medication without a doctor’s orders.
• Do not take aspirin or any product that contains aspirin.
• Do not take NSAIDs (nonsteroidal anti-inflammatory drugs), as it increases the risk of bleeding.
• Avoid sports and activities that can lead to falling or injury.
• Wear shoes or slippers to protect the feet.
• Do not use tampons, instead use sanitary pads.

2. The nursing assessment of a client who is immobile reveals a red area over the coccyx.

The nursing assessment reveals that the patient might be in the first stage of pressure ulcer, as he/she has a red area present over the coccyx. The risk factor in this client which can lead to pressure ulcers is immobility. A pressure ulcer is a localized injury to the skin or underlying tissue generally over a bony prominence, as a result of pressure or shear. In the first stage of pressure ulcers, the skin is intact with non-blachable redness in a localized area over a bony prominence. The area may be painful, warm or cooler, soft and firm. This indicates that the client is at risk for pressure ulcers.

The following nursing actions must be implemented:

• The patient should be repositioned every two hourly.
• Keep the patients skin dry and clean.
• Avoid massaging vigorously over the coccyx.
• Provide adequate intake of proteins and calories.
• Prevent the area from being moist.
• Use comfort devices or positioning devices to prevent prolonged pressure over the coccyx.
• Keep the sheets dry and wrinkle-free.
• Keep the head of the bed as low as possible to prevent shearing.