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Chapter 14:Platelet

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?