Bleeding Precautions for a Patient with Severe Thrombocytopenia: A Guide for Nurses and Healthcare Professionals

A 69-year-old patient was diagnosed with lung cancer. He is receiving chemotherapy and the nurse caring for him reviewed the laboratory results showing a platelet count is 18,000/mm³ and a pH of 7.36. Which of the following measures would the nurse implement based on the laboratory result?- Respiratory isolation- Reverse isolation- Bleeding precautions- Contact isolation

Based on the laboratory results provided, the nurse would implement bleeding precautions

Based on the laboratory results provided, the nurse would implement bleeding precautions.

A platelet count of 18,000/mm³ indicates severe thrombocytopenia (low platelet count), which puts the patient at a high risk of bleeding or hemorrhage. Platelets are responsible for blood clotting and preventing spontaneous bleeding. A normal platelet count typically ranges between 150,000 to 450,000/mm³, so a count of 18,000/mm³ is significantly below the normal range.

Chemotherapy can cause bone marrow suppression, leading to low platelet count. The patient’s diagnosis of lung cancer and treatment with chemotherapy are likely contributors to his thrombocytopenia.

To prevent or minimize the risk of bleeding, the nurse would initiate bleeding precautions. Some measures that may be implemented include:

1. Minimizing or avoiding invasive procedures: This includes avoiding unnecessary injections, intravenous catheter placements, or arterial punctures. If these procedures are necessary, the nurse would take extra precautions to secure and apply pressure to the puncture site to prevent bleeding.

2. Using soft-bristled toothbrushes and avoiding vigorous oral hygiene techniques: This helps prevent gum bleeding and oral tissue trauma.

3. Promoting a low-risk environment: The nurse would ensure that the patient’s room is free from any sharp objects that may cause injury.

4. Applying pressure to any bleeding sites: If bleeding occurs, direct pressure should be applied to the site to control and stop the bleeding.

It is worth noting that respiratory isolation, reverse isolation, and contact isolation are infection control measures used for patients with communicable diseases to prevent the spread of infections. However, the laboratory results provided do not indicate an infection-related issue, so these measures would not be appropriate in this scenario.

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