Initial Grading Reminder
CTCAE grading of bruising:
Grade 1 (Mild): Localized or in dependent area
Grade 2 (Moderate): Generalized
Assessment and Grading
Characterize the symptom (onset, pace)
Ask the patient:
Do you have any kidney/liver problems? Are you on blood thinners? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly?
Grade the symptom
Ask the patient:
Please send a photo, if possible. Where are you bruising? How many bruises do you have?
Patient Query Regarding Other Symptoms/Red Flags
Ask the patient:
Do you have any pain in your abdomen (belly), bloating, sleepiness, or yellowing of skin? Is your thinking clear or do you feel foggy?
Patient Factors to Consider That Affect the Approach to Intervention
Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?
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Click Here for Telephone Triage
Suggested Intervention
A patient with moderate bruising should be seen.
Patients with any of the red-flag symptoms need to be seen immediately.
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Click Here for In-Office Triage
Nursing Assessment of Potential Causes
[tab category='Hepatotoxicity' header="Hepatotoxicity - Nursing Assessment" tab1='Look' tab2='Listen' tab3='Recognize'][tab category='Nephritis' header="Nephritis - Nursing Assessment" tab1='Look' tab2='Listen' tab3='Recognize']
Differential Diagnosis
What do you suspect is the cause of increased bruising?
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