Thrombocytopenia
Labs
Pathophysiology
-
Decreased number of platelets
Diminished production= infection
Increases destruction= medication
Idiopathic= pregnancy
Causes
-

Platelets
>150,000
100,000= Major Risk
<50,000= deadly
**Patients who are immunocompromised**
Immune Thrombocytopenic Purpura (ITP)= give steroids
Thrombotic Thrombocytopenic Purpura (ttp)= rare, mainly female
Heparin Induced thrombocytopenic (HIT)
Liver disease (Hep. / Cirrhosis)
Medications (Immunosuppressants)
Signs and Symptoms
Complications
*Many asymptomatic*
! Bleeding !
‧ Hemorrhage
‧ Mucosal (nose/gingival) bleeding
‧ Petechiae (red freckles, usually on
abdomen)
‧ Purpura (small hemorrhage under skin or
Mucus membranes)
‧ Ecchymosis (blood under skin)
‧ Fatigue/dizziness
‧ Tachycardia
‧ Hypotension
- Huge Risk for injury, like a
ticking time bomb
- Priority Nursing diagnosis
is Risk for injury
Teaching
- Notify HCP at any signs of
bleeding
- No razors
- use soft bristle toothbrush
- No Nsaids (Asprin)
Treatments and Interventions
- Notify HCP
- Find and treat underlying cause
- Corticosteroids (First)= Will decrease platelet destruction
*Do not abruptly stop= Addison’s Crisis*
- Splenectomy
- Transfusion when <20,000
- Monitor Hgb, Hct, Platelets, coag
- Increase Fluids and Fiber
- Hold P’s= Heparin, aspirin, clopidogrel, enoxaparin