15 alteration to thrombocyte

Question 1

ALTERATIONS TO PLATELETS

AND COAGULATION

Answer 1

1. Platelet disorders - can
involve either a decreased
number of platelets
(thrombocytopaenia) or
defective platelet function.
2. Disorders of coagulation
(inherited and acquired)
3. Haemostasis therapy

Question 2

Thrombocytes number

Answer 2

platelets (150,000–450,000 per microlitre (μl) of blood

for most healthy individual)

Question 3

Platelet production in the marrow is regulated in part by

Answer 3

the hormone
thrombopoietin (TPO), which stimulates the production and
differentiation of megakaryocytes from the myeloid stem cell.

Question 4

Platelets play an essential role

Answer 4

in the control of bleeding. They circulate
freely in the blood in an inactive state, where they nurture the
endothelium of the blood vessels, maintaining the integrity of the vessel.
Platelets have a normal life span of 7 to 10 days

Question 5

THROMBOCYTOPAENIA

Answer 5

 Reduction of platelets – platelets go below 150,000 (150 × 109
/L).
 Results in abnormal haemostasis (prolonged or spontaneous bleeding)
 Primarily an ‘acquired’ disorder; some examples are Immune
thrombocytopenia purpura (ITP), Thrombotic thrombocytopenia purpura
(TTP) and Heparin-induced thrombocytopenia (HIT)

Question 6

Reduction of platelets causes

Answer 6

• decreased production of platelets within the bone marrow
• increased destruction of platelets or
• increased consumption of platelets

Question 7

An antibody (Ab),

Answer 7

also known as an immunoglobulin (Ig), is a large,
Y-shaped protein used by the immune system to identify and
neutralise foreign objects such as pathogenic bacteria and viruses.

Question 8

The antibody recognises

Answer 8

a unique molecule of the pathogen, called
an antigen. Each tip of the “Y” of an antibody contains a paratope
(like a lock) that is specific for one particular epitope (like a key)
on an antigen, allowing these two structures to bind together with
precision.

Question 9

Using this binding mechanism, an antibody can tag a microbe or

Answer 9

an
infected cell for attack by other parts of the immune system, or
can neutralise it directly (for example, by blocking a part of a virus
that is essential for its invasion).

Question 10

CAUSES

autoimmune disease

Answer 10

 Aspirin. Reduces normal platelet aggregation, and the prolonged
bleeding time lasts for several days after aspirin ingestion.
 Anaesthetic agents
 Anticoagulation agents
 Cardiovascular drugs (beta blockers, GTN)
 Antibiotics
 Anti-inflammatory agents (non-steroidal)
 Food and food additives (turmeric, cloves, garlic, fish oil, ginger)
 Herbal supplements (kava kava, Vit E, gingseng, gingko)

Question 11

THROMBOCYTOPENIA

SIGNS AND SYMPTOMS

Answer 11

 Patients are often asymptomatic.
 Most common symptom is mucosal or cutaneous
bleeding: Petechiae, Purpura, Ecchymosis
 Prolonged bleeding after routine procedures
 Internal bleeding may manifest as weakness,
fainting, dizziness, tachycardia, abdominal pain, or
hypotension.
 Haemorrhage is a major complication

Question 12

THROMBOCYTOPENIA

 Multidisciplinary Care

Answer 12

 Removal or treatment of the underlying cause/disorder
 Avoid aspirin and other medications that affect platelet function or
production.
 Therapy initiated if platelets ↓ 50,000
 Drug therapy
 Splenectomy
 Immunosuppressive therapy
 Platelet transfusions

Question 13

NURSING MANAGEMENT

THROMBOCYTOPENIA

Answer 13

 Health promotion
 Acute intervention
 Prevent or control haemorrhage; bleeding precautions limit needle sticks, avoid invasive procedures).
 If subcutaneous injection is unavoidable, use small-gauge needles and application of pressure or ice
packs after.
 Teach self-care measures to reduce risks of bleeding.
 Monitor the platelet count, coagulation studies, Hb, and Haematocrit.
 Administer platelet transfusions.
 Blood component therapy
 Ambulatory and home care