A nurse working in a community health clinic is obtaining a history from a client recently diagnosed with idiopathic thrombocytopenic purpura. Which statements by the client should concern the nurse? Select all that apply.

Rationale: A. "I use a soft toothbrush" is not concerning. Clients with idiopathic thrombocytopenic purpura (ITP) have an increased risk of bleeding due to low platelet counts. Using a soft toothbrush is a recommended safety measure to prevent gum bleeding, reflecting safe self-care behavior. B. "I use an electric razor now" is not concerning. Electric razors reduce the risk of cuts compared to traditional razors, which is especially important for clients with low platelets. This statement demonstrates that the client is taking appropriate precautions to minimize bleeding risk. C. "I take ibuprofen for my headaches" is concerning. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and increase the risk of bleeding. For a client with ITP, this behavior represents a serious safety concern and requires immediate patient education to prevent bleeding complications. D. "I have only red wine with my meals" is concerning. Alcohol can impair platelet function and worsen bleeding tendencies. For a client with ITP, regular alcohol consumption increases the risk of spontaneous bleeding and is considered unsafe behavior.