Question

Georgia Paris, a 32-year-old female client with a history of type 1 diabetes, is admitted with idiopathic (immune) thrombocytopenia purpura (ITP) and has a platelet count of 20,000/mm³. The client has a recent history of recovering from a viral infection. She recently developed a urinary tract infection, which is being treated with a sulfa antibiotic, trimethoprim-sulfamethoxazole (Bactrim). The client reports that she had unusual heavy bleeding with her menstrual cycle for 10 days. The nurse notices scattered purpura on the client’s extremities and trunk area. The nurse reviews the physician orders, noting that the sulfa antibiotic has been stopped and the client will be started on ciprofloxacin and prednisone with tapering doses. The physician also orders fingerstick blood sugars (FSBS) every 6 hours with high-dose sliding scale coverage along with the 30 units of Humulin 70/20 twice daily that the client normally takes at home. The LPN/LVN needs to manage the client’s care.

What nursing responsibilities does the nurse need to consider when managing Ms. Paris’s nursing care? (5 correct responses are required)

Answer 1

The nursing responsibility which the nurse need to consider in Ms.Paris's case are

• Assess for any signs of bleeding ,heamaturia(as this is possible due to very low platelet count)
• Monitor blood glucose levels as the patient is administered insulin (this may lead to hypoglycemia)
• Provide aseptic care to patient (as patient is having infection of urinary tract.Prednisone further decrease the immunity system and increase the chance of infection, development of infection in type 1 diabetic patients takes a longer time to heal )
• Monitor the vital signs to get the baseline data and assess patient's status (this helps to prevent complications by taking necessary interventions)
• Insert IV catheter to transfuse platelet (as the platelet count are very less and transfusion is the first line of treatment for these type of patients)