Thrombocytopenia occurs when the circulating platelet count falls below 150 x 103/µL (150 x 109/L). Thrombocytopenia increases the risk of bleeding. Therefore, nursing care focuses on injury prevention and implementation of bleeding precautions, including: Avoiding venipunctures and intramuscular (IM) injections. Alternative routes of administration, such as oral, should be used if available. If an injection is necessary, the smallest appropriate needle should be used to minimize bleeding. Monitoring for signs of bleeding (e.g., bruising, petechiae). Reducing risk for physical trauma (e.g., fall prevention); applying ice if trauma occurs.

Retinal detachment occurs when the retina separates from the choroid (vascular layer of the eye). It can occur from trauma or spontaneously. Risk factors include myopia, eye injury (surgery), family history, previous detachment, and aging. Symptoms include visual abnormalities (e.g., floaters, light flashes) and painless loss of peripheral or central vision.
Prompt treatment is needed to preserve vision. Pneumatic retinopexy is often required and involves an injection of a gas or liquid bubble into the vitreous cavity to push the retina into place until it heals.
Discharge instructions should stress the importance of avoiding activities that could cause increased intraocular pressure (IOP) and repeat detachment. Teaching was effective if the client understands to: Avoid lifting their toddler and avoid activities requiring forward bending to prevent increased intraocular pressure. In addition, positioning is important to keep the bubble in contact with the retina. Correct post-procedural positioning depends on the detachment location and the surgeon’s instructions.

When a client develops stroke-like symptoms, such as weakness and slurred speech, the nurse should first determine the presence or absence of lateralizing signs to help discern between a stroke or other systemic causes of stroke-like symptoms (e.g., delirium, hypoglycemia). Lateralizing signs, such as unilateral facial droop or arm weakness, are indicators of a neurological deficit on one side of the body, typically indicating a potential stroke instead of another systemic issue.  Performing a focused neurologic assessment, like asking the client to show their teeth, raise both arms, or speak a simple sentence, can provide immediate feedback on whether there is facial drooping or other lateralizing signs of a stroke. This is a priority assessment to determine whether it is appropriate to activate the emergency stroke response team.