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RNSG 1343 Thrombocyt

Chapter 29 Platelet disorders Thrombocytopenia

Thrombocytopenia – Platelet count less than 100,000 per mL blood – Can lead to abnormal bleeding – Platelets of less than 20,000 can lead to spontaneous bleeding and hemorrhage from minor trauma.
Thrombocytopenia results from one of three mechanisms – Decreased production – Increased sequestration in spleen – Accelerated destruction
Control of bleeding – Complex interactions between damaged tissue, blood vessel, platelets, clotting factors – Processes to dissolve clots once bleeding has been controlled – Thrombopoietin produced by liver, kidney, smooth muscle, bone marrow – Platelets
Immune thrombocytopenic purpura – Autoimmune disorder—accelerated platelet destruction
Manifestations of Immune thrombocytopenic purpura • Petechiae • Purpura • Bruising • Epistaxis • Hematuria • Excess menstrual bleeding • Bleeding gums
Thrombotic thrombocytopenic purpura – Rare disorder – Thrombi occlude arterioles/capillaries of microcirculation
Manifestations of Thrombotic thrombocytopenic purpura • Purpura • Petechiae • Headache • Seizures • Altered consciousness
Heparin-induced thrombocytopenia – Result of abnormal response to heparin therapy
Manifestations of Heparin-induced thrombocytopenia • Bleeding • Arterial thrombosis • Venous thrombosis
Diagnostic tests for thrombocytopenia – CBC with platelet count – Antinuclear antibodies – Serologic studies – Bone marrow examination
Treatments for thrombocytopenia – Platelet transfusions – Plasmapheresis or plasma exchange therapy
Surgery for thrombocytopenia – Splenectomy
Nursing Diagnosis for thrombocytopenia – Ineffective Protection – Impaired Oral Mucous Membranes
Created by: pdimple