Explanation
•Using a soft toothbrush and avoiding dental floss promotes healthy oral cavity without the risk of bleeding and impairment of skin integrity, which could lead to infection.
•The patient is severely thrombocytopenic which puts him at high risk for bleeding and disruption of skin integrity and mucous membranes.
•Advising the patient to have a low-residue diet will not provide enough fiber to stimulate normal bowel movements which is necessary for thrombocytopenic patients to prevent constipation.
•Fingernails and toenails must be filed, not cut, because sharp edges from cutting could tear the skin.
•Additional IV lines are not needed because the patient has an intact central venous access device.
•Normal ranges:
WBC: 4,000-10,000 cells/ml
Hemoglobin: 14-18 g/dl (men), 12-16 g/dl (women)
Hematocrit: 42-52% (men), 37-47% (women)
RBC: 4.5-5.0 million
Platelets: 150,000-400,000