A client with leukemia receiving myelosuppressive chemotherapy has a platelet count of 25,000/mm3. Which intervention is most important to include in the plan of care?

• A. Assess urine and stool for occult blood
• B. Encourage high-activity levels to improve mood
• C. Increase dietary iron to prevent anemia
• D. Administer additional platelet transfusions every 6 hours

Answer: (A)

The main idea is preventing and detecting bleeding in a patient with low platelets from chemotherapy. When platelet counts are as low as 25,000/mm3, the risk of spontaneous bleeding rises, especially from mucous membranes. Checking urine and stool for occult blood is a key way to detect hidden bleeding in the GI or urinary tract early, so you can intervene promptly and protect the patient from major hemorrhage. This monitoring guides safety measures and helps determine whether further actions, such as transfusion, are needed.

Encouraging high activity could lead to injuries and bleeding in someone with thrombocytopenia. Increasing dietary iron won’t prevent bleeding since the issue isn’t iron deficiency but a depleted platelet supply. Administering platelet transfusions every 6 hours isn’t appropriate here; transfusions are reserved for actively bleeding or when platelets are dangerously low, with decisions guided by bleeding status and specific thresholds rather than a fixed schedule.