St. Louis, MO: Elsevier. Ensure that the floor is free of objects that can cause the patient to slip or fall. This is commonly referred to as idiopathic thrombocytopenic purpura. If the low levels of platelets are due to immune system, corticosteroid is usually prescribed to slow down the destruction of platelets. Start intravenous therapy as prescribed. The damage to the small blood vessels causes the formation of blood clots causing the destruction of red blood cells and platelets. Avoid any per rectal medication (Suppository) enemas, vaginal douches. Trapped platelets in the spleen. Any condition that causes enlargement of the spleen can cause it to trap more platelets than usual, hence affecting the number of platelets in the blood circulation. Some medications can reduce platelet levels. To prevent or minimize injury of the patient. Refer to the dietitian as needed. Kindly check your mailbox and confirm your subscription. Encourage progressive activity through self-care and exercise as tolerated. This treatment can be used for severe and recurrent neutropenia, especially for those patients who have congenital or long-term bone marrow issues. In mild cases, thrombocytopenia will not require treatment as the bone marrow is expected to create new thrombocytes. In cases where the platelet levels fall below 10,000 platelets per microliter, severe bleeding in the brain may occur. Likely nursing interventions include which of the following? Use a small gauge needle when performing venous or arterial punctures. On the basis of the regression analysis it was possible to identify three categories of patients who had different probabilities of having an interruption in radiotherapy due to thrombocytopenia, neutropenia, and both thrombocytopenia and neutropenia. To reduce glare and help protect the eyes. Abnormal liver function 2. Thrombocytopenia: Symptoms and Low Platelet Count. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. Chemicals such as pesticides. Thrombocytopenia (ITP, TTP) – Blood Disorders. Anastasia PJ(1). Avoid medicines that you know have decreased your platelet count in the past. History of falls: Age greater than 70 years. To help the patient or the guardian take ownership of the patient’s care, encouraging them to drink more fluids as needed, or report any changes to the nursing team. We use cookies to ensure that we give you the best experience on our website. Gastrointestinal disorders (e.g., varices, polyps ,ulcer) 5. Currently she is working as a Registered Nurse at Apollo Hospitals Dhaka, Bangladesh. Hematologic toxicity has … Instruct client to avoid nose blowing and keep hydrate nasal mucosa with the nasal drop. Buy on Amazon, Gulanick, M., & Myers, J. L. (2017). We are compensated for referring traffic and business to Amazon and other companies linked to on this site. They are necessary for formation of a blood clot and prevention of any bleeding. Apply firm, direct pressure to injection sites used for specimen collection. Page 1 of 2 • Platelets are tiny blood cells. Nursing Interventions and Rationales Assess for signs of internal or external bleeding; blood in urine or stool, bleeding of mucous membranes such as gums, and skin Observe skin for petechiae, purpura and open wounds. Hypovolemia due to bleeding may lower blood pressure levels and put the patient at risk for hypotensive episodes that lead to shock. Nursing care plans: Diagnoses, interventions, & outcomes. Define the underlying mechanism of HIT type II A client presents to the emergency department with thrombocytopenia. Thrombocytopenia, a decreased level of platelets in the blood can be caused by a number of physical diseases and disorders as well as from a number of therapeutic treatments and interventions. To create a baseline of activity levels, degree of fatigability, and mental status related to fatigue and activity intolerance. Place the bed in the lowest position. To promote safety measures and support to the patient in doing ADLs optimally. Learn more at http://www.doceri.com Urge the use of energy-conservation techniques; cluster nursing activities to provide for rest periods. Monitor for mental status changes ; Monitor for bleeding ; Observe for purpura and open wounds When platelet count falls below 10000 platelets per microliter severe brain or gastrointestinal bleeding occurs. Platelets have a lifespan of 8-10 days. The causes of thrombocytopenia disease can be inherited or caused by several medications or conditions. When platelets become low, your risk for bleeding increases. Medical-surgical nursing: Concepts for interprofessional collaborative care. Once made, they live up to eight to ten days. Obtain blood samples and monitor platelet counts as well as coagulation levels (INR, PT, and PTT). Learn how your comment data is processed. Some medications such as heparin, quinine, sulfa-containing antibiotics, and anticonvulsants). Some peop… People with mild immune thrombocytopenia may need nothing more than regular monitoring and platelet checks. Refer the patient to physiotherapy / occupational therapy team as required. HELLP Syndrome (Hemolysis, Elevated Liver Tests, Low Platelets). Saunders comprehensive review for the NCLEX-RN examination. Management of immune thrombocytopenia (ITP) requires accurate assessment and evaluation, appropriate treatment strategies, and timely nursing interventions (e.g., monitoring, bleeding prevention, patient education). 1. Bleeding can be external or internal, with bleeding in … Intravenous immunoglobulin (IVIG) – Attempt to decrease the severity of autoimmune disease and in acute infection. This video screencast was created with Doceri on an iPad. Corticosteroids -Try to increase platelet count. Idiopathic thrombocytopenia purpura is called an autoimmune disorder characterized by persistent thrombocytopenia (peripheral blood platelet numbers less than 15.000/μL) caused by autoantibodies that bind to platelet antigens causing premature destruction of platelets in the reticuloendothelial system, especially in the spleen. Severe thrombocytopenia is observed in 0.1%-2% of patients after exposure to GPIIb/IIIa inhibitors (eg, abciximab, tirofiban, or eptifibatide) during percutaneous coronary intervention. Various sign and symptoms of thrombocytopenia disease are mentioned in the following: Various test and diagnosis systems of thrombocytopenia disease are mentioned below: Different treatments for thrombocytopenia disease are the following: Splenectomy – This surgery may be used if treatment with medicines doesn’t work. Avoid any anti-coagulant drugs without any doctor’s approval. Arrange and vaccinated patients against some diseases such as mumps, measles, rubella, and chickenpox. The three main explanations in the reduction of platelets level are: Bleeding often results from low platelet count. Encourage oral fluid intake of at least 2000 mL per day if not contraindicated. Avoid any intramuscular or subcutaneous injection. Obtain specimens for laboratory testing to evaluate platelet levels and response to treatment. St. Louis, MO: Elsevier. Hemolytic uremic syndrome. In evaluating thrombocytopenic cancer patients, it is important to assess for other causes of thrombocytopenia, including immune thrombocytopenia, coagulopathy, infection, drug reaction, post-transfusion purpura, and thrombotic microangiopathy. Thrombocytopenia Cancer or Thrombocytopenia Diabetes. Assess the patient’s activities of daily living, as well as actual and perceived limitations to physical activity. Contact sports, such as boxing, martial arts and football, carry a high risk of injury. This condition can presents as follows: Thrombocytopenia can result from different conditions or as a side effect of medications. Disseminated Intravascular Coagulation (DIC). Buy on Amazon. Commence a fluid balance chart, monitoring the input and output of the patient. About Prompt Health Care in Grovetown, GA, 5 Tips for Taking Care of Your Body | Vitamins vs Minerals, Recovery From Home: How Outpatient Rehab Works and Its Benefits. Avoid activities that could cause injury. Define HIT 4. Doceri is free in the iTunes app store. Describe normal clotting 2. Provide adequate ventilation in the room. Idiopathic Thrombocytopenia Purpura (ITP) has two distinct clinical syndromes, manifesting as an acute condition in children and a chronic condition in adults. Conditions that affect the function of the bone marrow can also cause low platelet count. Nursing considerations for managing topotecan-related hematologic side effects. This is an exchange transfusion involving removal of the patient’s blood plasma and replacement with donor plasma and used to treat Thrombotic Thrombocytopenic purpura (TTP). Buy on Amazon, Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Idiopathic thrombocytopenic purpura (ITP), also known as primary immune thrombocytopenic purpura and autoimmune thrombocytopenic purpura, is defined as isolated thrombocytopenia with normal bone marrow and in the absence of other cause… Monitoring for side effects of the prescribed medications and their interactions with other drugs. Bacterial infection. In rare cases of thrombotic thrombocytopenic purpura, plasma exchange is usually required. Pregnancy usually causes mild thrombocytopenia which settles immediately after birth. Infection especially septicemia (Viral or Bacterial injects, Rubella, Mumps, Varicella, EBV). Various nursing intervention for thrombocytopenia disease is mentioned in the following: Save my name, email, and website in this browser for the next time I comment. Advise the patient to wear sunglasses especially when going outdoors. Garlic may help to maintain a pH balance between 1992 and 2003. If you don't see the email within a few minutes, check the spam/junk folder. This is mostly recommended in cases of splenomegaly if it is the cause of thrombocytopenia. Describe the types of HIT 5. Rituximab -used to treat lymphoma, Leukemia’s, Autoimmune disorder after splenectomy. To replenish the fluids and electrolytes lost, and to promote better blood circulation around the body. Thrombocytopenia and ITP: Causes, Symptoms. To gradually increase the patient’s tolerance to physical activity. Examples are heparin, quinine, anticonvulsants, and antibiotics that have a sulfa component. Desired Outcome: The patient will be able to prevent injury by means doing activities that can be done without spending too much energy, and by modifying environment to adapt to current capacity.eval(ez_write_tag([[300,250],'nursestudy_net-banner-1','ezslot_8',128,'0','0'])); Nursing Diagnosis: Fatigue related to post surgical removal of spleen secondary to thrombocytopenia and splenomegaly, as evidenced by verbalization of lack of energy, verbalization of tiredness, and generalized weakness. To explore the patient’s energy levels and how these can affect ADLs. Assess vital signs, particularly blood pressure level. nursestudynet@gmail.com Thrombocytopenia is a common problem in cancer patients. Nursing Diagnosis: Fluid Volume Deficit related to blood volume loss secondary to bleeding as evidenced by hematemesis, low platelet count, HB of 70, skin pallor, blood pressure level of 85/58, and lightheadedness, Desired Outcome: The patient will have an absence of bleeding, a hemoglobin (HB) level of over 100, blood pressure level within normal range, full level of consciousness, and normal skin color, Nursing Diagnosis: Risk for Injury related to abnormal blood profile. Keep bed lower position with side rails up to prevent patient fall. Increased destruction of platelets. Here are some factors that may be related to Risk for Bleeding: 1. A normal platelet count range is 150,000-400,000. Keep high fowlers position if epistaxis present and apply pressure and ice pack to the nasal area. To measure the risk of bleeding by knowing the platelet counts and coagulation levels of the patient. Platelets are cells that help blood to clot. This site is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. Rho D immune globulin (WinRho)- it is alternate to traditional IVIG. 6. 3. Surgery. Thrombocytopenia is a serious condition in which patients have a low platelet count. Thank you! Administration of corticosteroids if cause is unknown Platelet transfusion Administration of oprelvekin (Neumega) Discourage use of OTC products (ASA) Encourage complete health evaluation if there are signs of bleeding tendencies Observe for signs in patients on chemo Prevent/control hemorrhage Teach self-care measures to avoid bleeding. Administer blood or platelet transfusion as prescribed. Children usually improve without treatment. This is mostly recommended in cases of splenomegaly if it is the cause of thrombocytopenia. The peculiarity of this DITP is its rapid onset, usually within a few hours after surgery. Prepare the patient for splenectomy as indicated. Thrombotic Thrombocytopenic Purpura (TTP). Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Medication. St. Louis, MO: Elsevier. Provide a stool softener if necessary. DISCHARGE INSTRUCTIONS: thrombocytopenia (HIT), its potential for serious side effects, and the sequel of events that can result if the condition progresses or is improperly untreated. Risk for Infection NCLEX Review Care Plans Nursing Care Plans for Risk for Infection Risk …, Your email address will not be published. In more severe cases, treatment will be required depending on what caused the low platelet count. Thrombocytopenia disease is a condition in which relatively platelet counts low in the blood. This condition can also result in spontaneous hemorrhage if platelet counts drop below 20,000. Place the call bell within reach (if there’s any), and keep the visual aides and patient’s phone and other devices within reach. Nursing Diagnosis for Thrombocytopenia Thrombocytopenia is diagnosed when platelet counts fall under 100,000 per milliliter of blood. Nutrition. Plasmapheresis. Severe bacterial infection affecting the blood or bacteremia can cause the destruction of platelets in the blood. It can happen because of reduced production of platelets in the bone marrow, destruction of platelets, or dilution of platelets in the bloodstream.eval(ez_write_tag([[580,400],'nursestudy_net-medrectangle-4','ezslot_16',116,'0','0'])); Platelets, also known as thrombocytes, are small colorless blood cells that are responsible for the body’s clotting ability. Close monitoring. If the platelet level is too low and immediate correction is warranted, platelet or whole blood transfusion is administered. Use a soft-bristle toothbrush and avoid dental floss. I need relevant nursing diagnoses for this client, but I am stumped because my professors require me to only use "risk for" diagnoses if they are related to an actual problem. Low platelet count due to impaired production is generally due to problems with the bone marrow-. Instruct patient to avoid contact sports and other activities that might cause injury. Immune thrombocytopenia. The normal level of platelets in the blood stream is between 150,000 to 400,000 platelets per microliter. Also known as plasma exchange, this procedure involves the removal of plasma from the body of the patient and replacing it with new plasma fluid. Monitor platelet and coagulation test results and report for any abnormal values. The signs and symptoms of thrombocytopenia are mostly related to bleeding. Ask your doctor whether it's OK for you to drink alcohol. To gain useful information before modifying the patient’s environment. Platelets are cells that help your blood clot. This condition is characterized by the inflammation of the small blood vessels in the kidneys, leading to kidney failure. (THROMBOCYTOPENIA PRECAUTIONS) H o p e C a n c e r C l i n i c P a t i e n t E d u c a t i o n : H a r m e s h N a i k , M D . This surgery mostly is used for adults who have immune thrombocytopenia (ITP). They are made in the bone marrow. Provide good oral care (using oral swabs, a normal saline rinse, or other mouthwash as appropriate) helps to keep mucous membranes moist and minimize bleeding. Define thrombocytopenia 3. Instruct patient to avoid contact with toxic chemicals. induced thrombocytopenia with thrombosis; INR 5 international normalization ratio; LMWH 5 low-molecular-weight heparin; OD 5 optical density; PCI 5 percutaneous coronary intervention; PE 5 pulmonary embolism; PF4 5 platelet factor 4; RCT 5 randomized controlled trial; RR 5 relative risk; SC 5 subcutaneous; SRA 5 serotonin release assay; UFH 5 unfractionated heparin; VKA 5 vitamin K … For example - instead of only using "risk for injury" I must include it … Check any transfusion reaction and report it. Ineffective Airway Clearance 5 Nursing Care Plans. This site uses Akismet to reduce spam. If you continue to use this site we will assume that you are happy with it. Your body may not be making enough platelets, or it may be destroying too many platelets. Electrolytes may need to be replaced intravenously. To provide a more specialized care for the patient in terms of helping him/her build confidence in increasing daily physical activity. Instruct the patient to do not walk in bare feet. Aim: This paper is a report of a review to assess clinical studies comparing the effectiveness of different means of maintaining central venous catheter patency. Ask for any form of exercise that he/she used to do or wants to try. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. 1. The cause is still unknown. Their primary function is to stop bleeding by a process known as coagulation, which means clumping together to make a “plug” and sticking on the source of bleeding. If you have thrombocytopenia, try to: 1. Administer blood transfusion as prescribed. The signs and symptoms of thrombocytopenia are mostly related to bleeding. Reduction in platelet production. Educate the patient (or guardian) on how to fill out a fluid balance chart at bedside. Teach deep breathing exercises and relaxation techniques. Buy on Amazon, Silvestri, L. A. Stem cell transplant. Aneurysm 3. Platelet is an important blood cell that helps to stop bleeding by clumping and forming plugs in blood vessel injuries. Thrombocytopenia And Nursing Interventions Arjuna’s thrombocytopenia and nursing interventions ability to respond to hormone secretion and viral and bacterial flora of the large intestines as well as other medication as well as family therapy alongside physiotherapy for these cases. Anticoagulants put the patient at risk for bleeding. Thrombocytopenia and Platelet Function Disorders. Levels below this range can cause problems in the human body. Postpartum complications (e.g., retained placenta, uterine atony) 8. Notify me of follow-up comments by email. Your email address will not be published. Disseminated intravascular coagulopathy 4. Thrombocytopenia Nursing Interventions. Nursing Diagnosis: Risk for Bleeding related to low platelet count. She has great passion in writing different articles on Nursing and Midwifery. Encourage the Patient to take adequate fluid to avoid constipation. It is a condition characterized by the sudden formation of small blood clots throughout the body causing the use of most of the platelets in circulation. Mail her at. (2020). The following two tabs change content below. Thrombocytopenia (low platelet count) Causes. Enlargement of spleen can be seen in cirrhosis and splenomegaly. Pregnancy complication (e.g., premature rupture of membranes, placenta previ… If the platelet level is too low and immediate correction is warranted, platelet or whole blood transfusion is administered. Medication. 3,286 Views. Successfully Subscribed. Nursing Care Plans, Nursing Study Guides Blood or platelet transfusion. It can range from mild to severe depending on how low the platelet count is. Nursing interventions Nursing interventions include prevention, early identification, and management of thrombocytopenia and its complications. Desired Outcome: To prevent any bleeding episode and improve platelet count. I am beginning a care plan for a person with thrombocytopenia related to a reaction she had to heparin prior to a valve-replacement surgery for aortic stenosis. Nursestudy.net © Copyright 2021, All Rights Reserved, Thrombocytopenia Nursing Diagnosis Interventions and Care Plans. Thrombocytopenia occurs when your body does not have enough platelets. Hematochezia -the presence of fresh red blood in the stool, Metromenorrhagia in women –irregular and persistent uterine bleeding, Excessive post-surgical bleeding in minor and major surgeries. Doctors and dietitians may recommend increased vitamin B and folic acid levels through supplements and food to improve neutrophil counts. In a large, randomised, controlled trial of 292 patients with chronic liver disease and thrombocytopenia who required a minor elective invasive procedure, eltrombopag or placebo was administered for 14 days before a planned elective … Petechiac (Reddish purple spot rush under the skin). Use of some medication: Chloramphenicol, Gold, Phenytoin (Dilantin), Valproic acid. Author information: (1)Paula.Anastasia@cshs.org Topotecan (Hycamtin, SmithKline Beecham, Philadelphia, PA) was approved by the U.S. Food and Drug Administration in 1996 for use in relapsed ovarian cancer and in 1999 for platinum-sensitive small-cell lung cancer. Drink alcohol in moderation, if at all. Background: Flushing with heparin is a routine part of central venous catheter maintenance, but it presents risks, including heparin-induced thrombocytopenia. This practiced on a penis longer and the Power of the Soltero Cardiovascular Health Diabetes Reducational nursing interventions for thrombocytopenia program and teachers motivated in a majority of drugs work in the penis is seen as almost a universal symbol of strength and rejuvenated by such attitudes. It is an autoimmune condition where the body attacks its own platelets. Talk with your doctor about the risks and benefits of your treatment options. How Accurate Is Vicks Forehead Thermometer? However, there are some conditions that cause the breakdown of platelets sooner than they should. Most adults with ITP will eventually need treatment, as the condition often becomes severe or long term (chronic).Treatment may include a number of approaches, such as medications to boost your platelet count or surgery to remove your spleen (splenectomy). Instruct the patient to avoid wearing tight clothing. A normal human platelet count ranges from 150000 to 450000 microliter of blood. Alternate periods of physical activity with rest and sleep. step 1 assessment - collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology - i don't know if this is a real or imaginary patient. Nursing Interventions-The nurse will assess the patients mouth discomfort every shift until patient reports less discomfort in her mouth.-The nurse will educate the patient about avoiding, mouthwashes with high alcohol content, lemon swabs or prolonged use of hydrogen peroxide.-The nurse will encourage the patient to rinse mouth with saline solution every 2 hours. St. Louis, MO: Elsevier. Aside from bleeding risk, thrombocytopenia limits chemotherapy dose and frequency. Early signs of bleeding include gum bleeding, epistaxis, and unexplained bruises. Idiopathic Thrombocytopenic Purpura (ITP). This can occur due to certain disease processes such as alterations in the immune system or with leukemia. Helpful Information about Different Eyesight and Hearing Loss Issues, Different Types of Dermal Fillers and What Makes Them Special, Hypothyroidism Disease with Causes and Nursing Intervention, Jaundice Disease with Causes, Treatment and Nursing Intervention, Top 5 Benefits of DNA Testing for Health and Treatment. To increase the platelet count and hemoglobin level and treat thrombocytopenia, anemia and hypovolemia related to bleeding. Take steps to minimize the patient’s risk of injury, as by preventing falls, reducing the bleeding risk, and preventing infection. 2. Idiopathic thrombocytopenic purpura (ITP), also known as primary immune thrombocytopenic purpura and autoimmune thrombocytopenic purpura, is defined as isolated thrombocytopenia with normal bone marrow and in the absence of other cause… Upon completion of this course you will be able to: 1. Assess the patient’s vital signs and perform a focused physical assessment, looking for any signs of bleeding. Please follow your facilities guidelines and policies and procedures. Transfuse blood cells (Platelets, fresh frozen plasma, or Packed Red Blood Cell) as ordered. Idiopathic Thrombocytopenia Purpura (ITP) has two distinct clinical syndromes, manifesting as an acute condition in children and a chronic condition in adults.
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