Thrombocytopenia

Question 1

Pathophysiology & Etiology of Thrombocytopenia: Decreased Platelet Production

Answer 1

1. Diseases of:
   a. Bone marrow
   b. Leukemia
   c. Aplastic anemia
   d. Myelosupressive therapy
   e. Radiation therapy

Question 2

Pathophysiology & Etiology of Thrombocytopenia: Decreased Platelet Production

Answer 2

1. Infection
2. Drug Induced Heparin
3. Disseminated Intravascular Coagulation (DIC)

Question 3

Pathophysiology & Etiology of Thrombocytopenia: Abnormal Distribution or Sequestration in spleen

Answer 3

1. Dilutional Thrombocytopenia

2. p Hemorrhage, lots of RBC’s Infusions

Question 4

What are the Clinical Manifestations of Thrombocytopenia When Platelet Count Drops Below 20,000/mm^3?

Answer 4

1. Spontaneous Petechiae
2. Ecchymoses @ site of minor trauma
3. Bleeding from mucosal surface

Question 5

Assessment for Thrombocytopenia

Answer 5

1. Health Hx
   a. Prior illnesses & episodes of bleeding
   b. Exposure to toxins
   c. Family Hx of bleeding
2. Current medications (Include OTC)
3. Perform head–> toe assessment looking for S/S of BLEEDING

Question 6

What are the Labs & Diagnostics tests performed for Thrombocytopenia?

Answer 6

1. CBC c Platelet count
   A. Decreased:
      a. Hgb
      b. Hct
      c. Platelets
2. PT & PTT
   A. Bleeding time prolonged

Question 7

What are good general Care Interventions for Thrombocytopenia?

Answer 7

1. Tx underlying cause
2. Platelet transfusions
3. If it’s Heparin Induced Thrombo:
   A. D/C Heparin

Question 8

Care Intervention for Thrombocytopenia:

Minimize Bleeding

Answer 8

1. Avoid plain razors
2. Avoid Hard Toothbrush & Floss
3. Avoid IM Injections
4. Give Stool Softeners
5. Activity may be Restricted

Question 9

Care Intervention for Thrombocytopenia:

Administer, Monitor, Evaluate

Answer 9

1. Administer blood products as ordered
2. Monitor for S/S of allergic reaction or volume overload
3. Evaluate Urine, Stool, & Emesis for gross occult blood.

Question 10

Care Plan: Assessment Ex

pt s/s & relevant data to RN Dx

Answer 10

Platelet count is 50,000/mm^3

Question 11

Care Plan: RN DX

include secondary & AEB

Answer 11

Risk for injury R/T bleeding secondary to thrombocytopenia

Question 12

Care Plan: Expected pt outcomes

goals/objectives, measurable & specific

Answer 12

1. Will prevent any bleeding episode during my shift

2. Platelet count maintained @ > 20,000mm^3 during my shift

Question 13

Care Plan: RN Interventions

2 minimum. (Independent & collaborative)

Answer 13

1. Will observe my pt frequently to prevent situations or equipment that may make pt bleed.
2. Will notify Dr. of any significant drop in platelet count.

Question 14

Care Plan: Rationales for Interventions

Answer 14

1. In preventing bleeding episodes I can maintain my pt free of injury.
2. To implement interventions such as platelet infusions.

Question 15

Care Plan: Evaluation of Expected Outcomes

review goals

Answer 15

1. Goal met; pt did not have any episodes of bleeding & platelet count was maintained >20,000mm^3