When should a nurse withhold IM injections in a client on chemotherapy?

Withholding intramuscular (IM) injections in a client undergoing chemotherapy is particularly important when the platelet count is low. Chemotherapy can cause myelosuppression, leading to a decrease in blood cell production, including platelets. A low platelet count, known as thrombocytopenia, significantly increases the risk of bleeding. This can lead to complications such as hematomas, excessive bruising, or bleeding at the injection site. Therefore, it is critical for a nurse to assess the patient's platelet levels prior to administering an IM injection to ensure the safety of the procedure.

In contrast, while pain, low white blood cell count, and nausea are relevant clinical considerations, they do not have the same immediate implications for the safety of performing an IM injection. Pain may indicate a need for a different site or method of administration, and a low white blood cell count raises concerns about infection risk but is not a direct contraindication for an injection. Nausea could influence the patient’s willingness to undergo the procedure, but it does not directly affect the appropriateness of the injection itself. Hence, the primary concern in this context is the patient's platelet count, which guides the decision to withhold the injection.