Week 5 Thrombocytopenia Flashcards
The nurse is caring for a child with systemic lupus erythematosus that has a platelet count of 47,000. Which assessment findings may be consistent with this laboratory
value?
Spoon-shaped nails and irritability
Fever and cloudy urine
Petechiae and epistaxis
Loss of balance and difficulty sleeping
Petechiae and epistaxis
This answer is correct because a low platelet count predisposes clients to a risk for bleeding. Clients with thrombocytopenia may not exhibit any symptoms. Clients who are symptomatic may display petechiae, nose bleeds (epistaxis), easy bruising, bleeding from gums, or prolonged bleeding from minor cuts.
Which statement best explains why a child with leukemia may experience thrombocytopenia?
Abnormal cells accumulate in the bone marrow, interfering with platelet production
Cancer cells damage the liver, which is responsible for thrombopoietin production
Leukemia cells increase production of abnormal white blood cells in the bone marrow
Abnormal cells decrease production of red blood cells, causing thrombocytopenia
Abnormal cells accumulate in the bone marrow, interfering with platelet production
This answer is correct because thrombocytopenia is the medical term for low platelets. Platelets are manufactured in the bone marrow. In children with leukemia, the abnormal cancer cells accumulate in the bone marrow and interfere with platelet production, which leads to thrombocytopenia.
The nurse is caring for a teenage client with thrombocytopenia. Which statement indicates that the teenager understands the nurse’s teaching about thrombocytopenic precautions?
“I will play golf but not football when I go back to school next week.”
“I will use a thick-lathering shaving cream and a sharp disposable razor when shaving.”
“I will take ibuprofen if I have any headaches or muscle pains.”
“I will use over-the-counter garlic and vitamin E supplements to help my nutrition.”
“I will play golf but not football when I go back to school next week.”
This answer is correct because the teenager with a low platelet count displays an increased risk for bleeding. Thrombocytopenia precautions for this teenager include the importance of avoiding contact sports that could lead to injury and bleeding. This statement demonstrates that the teenager understands the importance of choosing activities and sports that do not feature direct contact (golf vs football).
The nurse is caring for a pediatric client with a platelet count of 96,000. Which intervention(s) should the nurse take? Select all that apply.
Withhold the client’s morning dose of heparin
Obtain vital signs
Contact the health care provider
Initiate IV access
Place intubation equipment at the bedside
Withhold the client’s morning dose of heparin
Obtain vital signs
Contact the health care provider
This answer is correct because a platelet count of 96,000 per microliter of blood is significantly decreased. Heparin is an anticoagulant used to prevent clot formation. The nurse should withhold the scheduled dose of heparin to prevent increased risk of bleeding and notify the health care provider.
The nurse is caring for a pediatric client with a platelet count of 54,000. The nurse recognizes which causative factor is most likely responsible for this child’s condition?
Cirrhosis
Acetaminophen overdose
Immunosuppressant medication
Immune thrombocytopenia purpura
Immune thrombocytopenia purpura
This answer is correct because immune thrombocytopenia purpura is the most common cause of thrombocytopenia in children. ITP results when the immune system mistakenly recognizes the body’s platelets as foreign and attacks them. Children who develop ITP may have had a recent viral infection.
The nurse in the intensive care unit (ICU) is caring for a client with a history of thrombocytopenia with a platelet count of 9,500 cells/mm3. Which blood product should the nurse anticipate the healthcare provider will prescribe?
Packed red blood cells
Fresh frozen plasma
Platelets
Whole blood
Platelets
Regardless of the cause, platelet transfusion is indicated in all clients with a severe hemorrhage or platelet count below 10,000/mm3.
The hematology clinic nurse is reviewing platelet physiology with a newly graduated nurse. The nurse should teach the newly graduated nurse that platelets arise from which type of cell in the bone marrow?
Megakaryocyte
Erythrocyte
Monocyte
Granulocyte
Megakaryocyte
Platelets arise from megakaryocytes, which derive from hematopoietic stem cells that give rise to all types of blood cells.
A nurse is caring for a client diagnosed with thrombocytopenia. What is the most appropriate nursing diagnosis to assign to this client?
Risk for aspiration
Risk for ineffective coping
Risk for bleeding
Risk for falls
Risk for bleeding
Thrombocytopenia occurs when a client has a reduced platelet count. Platelets are the cells that form the initial response to injury, either to the skin or to the blood vessel walls. Clients with thrombocytopenia have a platelet deficiency; therefore, they cannot adequately form platelet plugs at the site of injury, thus leading to increased bleeding.
The nurse is caring for a client on the surgical unit who has a history of thrombocytopenia. When assessing the client’s recent blood work, which component is noted to be decreased?
Elimination tool
White blood cells
Platelets
Red blood cells
Iron
Platelets
Thrombocytopenia is a condition characterized by platelet deficiency. Typically, there are between 150,000 and 450,000 platelets per microliter (mL) of blood; however, in clients with thrombocytopenia, this number goes below 150,000 cells per mL.
The nurse is assessing a client who was brought to the emergency department by ambulance following a fall in their home. The client has a history of alcohol use disorder and takes aspirin daily. The nurse notes their serum platelet count is 67,000/mm3 and suspects the client has thrombocytopenia. Which assessment finding should the nurse associate with this condition?
Scattered pustules and comedones on the client’s face
Rounded, straight nail beds with bulging fingertips
Several areas of ecchymosis in various stages of healing
An area of dry, necrotic tissue over a bony prominence on the lower extremity
Several areas of ecchymosis in various stages of healing
Bruising, or ecchymosis, occurs due to accumulated blood under the skin. Clients with thrombocytopenia may experience excessive bleeding and hematomas because they have a platelet deficiency. This finding would be consistent in a client with thrombocytopenia.
