A client has been admitted with a diagnosis of pulmonary embolism and is receiving heparin infusion. What safety priority does the nurse include in the plan of care?

Choice A rationale While bleeding precautions are essential when a client is receiving a heparin infusion, avoiding dental floss is often an overly restrictive measure, especially if the client is at low risk for spontaneous bleeding. Instead, clients are typically taught to use a soft-bristle toothbrush and avoid forceful flossing, but complete avoidance of all oral hygiene adjuncts is usually not required. Choice B rationale Heparin infusion carries a significant risk for the development of Heparin-Induced Thrombocytopenia (HIT), a severe, immune-mediated adverse reaction where the platelet count drops due to antibody formation. Monitoring the platelet count daily is critical to detect HIT early, as a drop below the client's baseline or below the normal range (150,000-450,000/microL) necessitates immediate discontinuation of the heparin infusion. Choice C rationale Ensuring adequate staffing is an important management decision for overall client care and safety on the unit, but it is a general administrative measure, not a specific safety priority directly related to the physiological or pharmacological management of a client receiving a heparin infusion. The focus for anticoagulation safety must be on close physical and laboratory monitoring for bleeding or HIT. Choice D rationale Notifying radiology of an impending scan is a logistical step in preparing the client for a diagnostic procedure. It is necessary for scheduling and coordination but does not constitute a priority safety intervention directly related to the risks associated with heparin therapy, such as bleeding or the potential for Heparin-Induced Thrombocytopenia (HIT).