Which nursing interventions are appropriate for managing ITP? Select all that apply.

A. Avoid IM injections: In immune thrombocytopenic purpura (ITP), platelet counts are low, increasing the risk of bleeding and hematoma formation with intramuscular injections. Using alternative routes such as oral or subcutaneous administration when possible reduces trauma to the tissues and prevents uncontrolled bleeding. B. Avoid rectal thermometers: Rectal instrumentation can cause mucosal trauma and bleeding in patients with thrombocytopenia. Avoiding rectal thermometers helps prevent localized hemorrhage, which can be difficult to control in patients with ITP. C. Use a soft toothbrush: Patients with ITP are at increased risk of oral mucosal bleeding due to low platelet counts. Using a soft-bristled toothbrush minimizes trauma to the gums during oral hygiene and reduces the risk of gingival bleeding. D. Administer aspirin for headache: Aspirin has antiplatelet effects and can exacerbate bleeding tendencies in ITP. It should be avoided; alternative analgesics like acetaminophen are preferred. Administering aspirin could precipitate serious hemorrhagic complications. E. Monitor stools for occult blood: Gastrointestinal bleeding is a potential complication of ITP. Monitoring stools for occult blood allows early detection of internal bleeding, even in the absence of overt symptoms, enabling timely intervention and management of hemorrhagic events.