Master Bleeding Precautions with Picmonic for Nursing RN

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Recommended Picmonics

Standard Precautions

Contact Precautions

Aseptic Technique

Droplet-Airborne Precautions

Prevention of Falls

Bleeding Precautions

Bloody-Carrie with Precaution-sign

Picmonic

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.

10 KEY FACTS

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

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.

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.

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.

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.

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.

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

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

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.

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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