A patient with newly diagnosed ITP is admitted with petechiae and ecchymoses. Which action should the nurse take first?

A. Prepare the patient for platelet transfusion: In immune thrombocytopenic purpura (ITP), platelet destruction is immune mediated, and transfused platelets are often rapidly destroyed unless there is severe or life-threatening bleeding. Platelet transfusion is not the first intervention for petechiae and ecchymoses without active hemorrhage. Immediate safety measures take priority. B. Institute bleeding precautions: ITP results in decreased platelet counts due to autoimmune destruction, increasing the risk for spontaneous bleeding. Implementing bleeding precautions—such as avoiding IM injections, using soft toothbrushes, and minimizing invasive procedures—reduces the risk of mucosal or internal hemorrhage. Preventing further bleeding is the priority upon admission. C. Encourage active range-of-motion exercises: Vigorous activity may increase the risk of bruising or internal bleeding in patients with thrombocytopenia. While mobility is important, activity should be limited or modified until platelet levels are stabilized. Preventing trauma is more urgent than promoting exercise at this stage. D. Administer aspirin for discomfort: Aspirin inhibits platelet aggregation by irreversibly blocking cyclooxygenase-1 (COX-1), impairing thromboxane A2 production. In a patient with already reduced platelet numbers, aspirin significantly increases bleeding risk and is contraindicated.