A client who is receiving chemotherapy for breast cancer develops thrombocytopenia. Which of the following interventions should the nurse include in the client’s plan of care?
A) Encourage the client to use a soft-bristle toothbrush.
B) Administer aspirin for pain relief.
C) Provide a diet high in roughage.
D) Apply warm compresses to areas of bruising.
The Correct answer and Explanation is:
Correct Answer:
A) Encourage the client to use a soft-bristle toothbrush.
Explanation:
Thrombocytopenia is a condition characterized by a significant reduction in the number of platelets in the blood, a common side effect of chemotherapy due to its impact on bone marrow function. Platelets are essential for blood clotting, and a low platelet count increases the risk of bleeding. In clients with thrombocytopenia, it is crucial to implement interventions that minimize this risk.
Using a soft-bristle toothbrush (Option A) is essential for reducing the risk of oral bleeding. The mucous membranes in the mouth are particularly vulnerable to injury, and hard-bristled toothbrushes can cause trauma, leading to bleeding in clients with thrombocytopenia. A soft-bristle toothbrush is gentle on the gums and reduces the likelihood of bleeding, which is a key consideration in the care of these clients.
Administering aspirin for pain relief (Option B) is contraindicated in clients with thrombocytopenia. Aspirin is an antiplatelet agent that inhibits platelet aggregation, further increasing the risk of bleeding. Therefore, it should be avoided in clients with low platelet counts.
Providing a diet high in roughage (Option C) may seem beneficial for overall health, but in thrombocytopenic clients, it can pose a risk. Rough, coarse foods can cause abrasions or tears in the gastrointestinal tract, leading to bleeding. Therefore, it is advisable to avoid such foods and focus on a diet that is gentle on the digestive system.
Applying warm compresses to areas of bruising (Option D) does not address the primary concern of thrombocytopenia, which is bleeding prevention. Warm compresses might soothe the bruised area, but they do not reduce the risk of bleeding and can sometimes exacerbate bruising by dilating blood vessels.
In conclusion, for a client with thrombocytopenia, the priority is to prevent bleeding. Encouraging the use of a soft-bristle toothbrush is a simple but effective measure to protect the client from oral bleeding, making it the most appropriate intervention among the options provided.