Disorders Jervonne Johnson Arleen Canta Veronica Alvarez Etiology of Thrombocytopenia
• Is any disorder in which there is a low platelets count (150,000 –
450,000) normal range • is often divided into 3 major causes of low platelets: Not enough platelets are made in the bone marrow. Increased breakdown of platelets in the bloodstream. Increased breakdown of platelets in the spleen or liver. • Function of platelets Platelets are made in your bone marrow along with other kinds of blood cells. They travel through your blood vessels and stick together (clot) to stop any bleeding that may happen if a blood vessel is damaged. Platelets also are called thrombocytes because a clot also is called a thrombus. Pathophysiology of Thrombocytopenia
• Decreased Platelet Production Folate/B12 deiciency Radiation therapy
Chemotherapy Drugs (e.g., alcohol, thiazides, phenytoin) Aplastic anemia Cancer in bone marrow • Decreased Platelet Survival Drugs (e.g., thiazides, digoxin, heparin, furosemide, certain antibiotics) Mechanical prosthetic heart valves Viral and bacterial infections Circulating immune complexes Increased destruction in the spleen Disseminated intravascular coagulation • Splenic Sequestration (Pooling) Splenomegaly Hypothermia • Platelet Dilution Massive transfusions with blood stored for more than 24 hours Signs/Symptoms:
• Petechiae and purpura are noted with a platelet
count below 50,000. • Spontaneous mucosal, deep tissue, and intracranial bleeding may be seen with a platelet count less than 20,000/mm3. • Fatigue is almost a common symptom among patients with ITP. • More serious cases of bleeding is also seen with patients with a count less than 10,000/mm3. Diagnosis
Low platelet count is PT/INR The
noted on Lab values bleeding time is such as CBC draw, prolonged and clot which will show the retraction is poor or platelet count. absent. Treatment
• The treatment for thrombocytopenia is based on the identiied
cause or mechanism and may include any of the following: discontinuation of any suspected drug; avoidance of aspirin and pharmacodynamically similar drugs that alter normal platelet function; and administration of corticosteroids, immunosuppressants, intravenous immunoglobulin (IVIg), rituximab, and thrombin receptor agonists such as romiplostim and eltrombopag to increase platelet production. Questions:
• What is the normal platelet count?
• Name one cause of Thrombocytopenia? • Name two lab values we should monitor as the primary nurse? • What are s/sx of Thrombocytopenia? • If a patient was diagnosed with Thrombocytopenia and we have order for aspirin daily? Would you give the ordered medication?