What is the most important discharge instruction for a client with a platelet count of 40,000 mcL?

The most important discharge instruction for a client with a platelet count of 40,000 mcL is to use a soft toothbrush and floss gently. This recommendation is crucial because a low platelet count, known as thrombocytopenia, increases the risk of bleeding. Using a soft toothbrush minimizes trauma to the gums, reducing the chance of gum bleeding during oral care. Gentle flossing is equally important to prevent injury to the delicate tissues in the mouth while maintaining good oral hygiene.

In contrast, taking aspirin with meals can further increase the risk of bleeding since aspirin is an antiplatelet medication that can inhibit the function of platelets, worsening the bleeding risk associated with low platelet levels. Continuing to use a straight-edge razor for shaving also poses a risk, as it can lead to cuts and nicks that may not stop bleeding easily. Taking a multivitamin daily, while beneficial for overall health, does not address the immediate concern of managing bleeding risk and is not the priority in this situation. Therefore, the guidance to use a soft toothbrush and floss gently is essential in this context of thrombocytopenia.