Registered Nurse (RN)
Fundamentals of Nursing
Patient Safety
Bleeding Precautions

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Bleeding Precautions

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Bleeding Precautions

Bloody-Carrie with Precaution-sign
Bleeding precautions should be implemented in any patient who has an increased risk of bleeding. A variety of conditions can lead to excessive bleeding, such as thrombocytopenia, leukemia, hemophilia, liver disease, following treatment with chemotherapeutic, anticoagulants, or antiplatelet medications. It is important to educate patients on the items or activities that should be avoided, as well as guidelines to follow.
Hard Foods
Hard Foods

Hard foods such as chips should be avoided because they can cause traumatic injury to the delicate lining of the mouth.

Aspirin Products

Aspirin prevents platelet function and should be avoided in patients who are at increased risk of bleeding as aspirin increases bleeding time. Ensure products given do not contain aspirin or salicylates.

Blowing Nose Forcefully
Bloody Nose and tissues

The nasal linings are very thin and blowing the nose decreases the mucous lining and increases the risk for bleeding. Advise patients who need to blow their noses not to completely block the nasal passage and to blow gently.

Straining During BMs
Straining Strainer-guy taking a BM

Advise patients to maintain a proper diet to avoid constipation. Patients should be educated on proper bowel techniques and to avoid excessive straining. Excessive straining causes increased abdominal pressure, which can irritate intestinal linings and cause potential hemorrhoid formation.

Enemas or Rectal Suppositories
Enema-Emma or Rectum-rectangle Pill

The colon is often a site for bleeding that cannot be easily observed. The lining of the bowel is very delicate and enemas and rectal suppositories should be avoided. If suppositories must be used, they should be lubricated adequately. Ensure that rectal thermometers are not used.

Pads and Monitor Menstruation
Tampon and Pads

Menstruating women should keep track of the number of pads they use per day. Abnormal usage should be brought to the attention of the healthcare provider. Additionally, patients should be educated that the use of tampons is contraindicated.

Soft-bristled Toothbrush
Feather Toothbrush

Always using a soft-bristled toothbrush decreases the risk for traumatic injury to the gums. Patients should be educated that flossing is contraindicated.

Electric Razor
Electric Razor

Electric razors are used because their tendency for skin lacerations is exponentially lower.

Limit Needle Sticks
Sharps Container with Needle Limit

Limiting the number of needle sticks in patients decreases the number of sites that could bleed and also the number of sites that require monitoring. Intramuscular injections should be avoided if possible.

Smaller Needle Size
Smaller Needle

When needle sticks cannot be avoided, use the higher gauge needle possible, as higher gauge needles have smaller lengths and diameters than small gauge needles. Apply pressure and or ice to the area after any injection.


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