Thrombocytopenia means having too few platelets in your blood, below 150,000/mm3. Low platelet counts increase the risk of bleeding. It occurs when the bone marrow doesn’t make enough platelets, such as with leukemia or other blood cancers, or when diseases destroy them. The spleen can also cause it by keeping too many platelets. In these cases, thrombocytopenia nursing interventions are necessary to prevent bleeding.
Types of Thrombocytopenia
Thrombocytopenia comes in various types, including:
- Immune thrombocytopenia (ITP) is when platelets are irregularly destroyed, often due to autoimmune diseases
- Thrombotic thrombocytopenic purpura (TTP) is rare and causes low platelets, anemia, fever, and issues with the nerves and kidneys. It forms tiny clots in blood vessels, using up platelets.
- Heparin-induced thrombocytopenia (HIT) happens 2 to 10 days after starting heparin treatment, causing platelet destruction and vessel damage due to an immune reaction to heparin.
Causes of Thrombocytopenia
- Pregnancy
- Bacteremia
- Viral infections
- Toxin exposure
- Too much alcohol
- Chemotherapy
Thrombocytopenia usually shows no symptoms, but the main sign is bleeding from the mouth or skin. This can mean nosebleeds, gum bleeding, or tiny red or purple spots on the skin. Severe cases, with platelets dropping below 10,000/mm3, can lead to dangerous internal bleeding and even death. Doctors can confirm thrombocytopenia with a simple blood test. Checking the patient’s medical history and doing a physical exam can help find out why they have thrombocytopenia.
Thrombocytopenia Nursing Diagnosis
Care for thrombocytopenia patients varies based on its cause. Treating the underlying issue might be enough. Nurses focus on preventing and spotting bleeding, and quickly managing it, so nursing interventions for low platelet counts are available. Patient education is vital, ensuring they and their family know about the disease, can report problems early, and prevent complications.
Nursing Care Plan for Thrombocytopenia
Thrombocytopenia means having low platelets, which raises the risk of bleeding and bruising. Below if a brief care plan overview, depending on the nursing diagnosis:
Risk for Bleeding
Related to:
- Too much bleeding
- Weak blood clotting
As seen by:
- A risk diagnosis means there are no symptoms yet. Nurses focus on preventing them.
Expected outcomes:
- Patients won’t show bleeding signs, with normal vital signs.
- Hemoglobin and hematocrit values will be normal.
Assessment
- Thorough physical examination:Physical assessment can help find signs of bleeding in thrombocytopenia. Watch for nosebleeds, gum bleeding, and bruises.
- Check vital signs: Too much bleeding can cause low blood pressure, a fast heartbeat, and changes in alertness.
- Keep an eye on lab results: Check blood levels like red blood cells, hemoglobin, hematocrit, and platelets with a blood test.
Intervention
- Keep checking coagulation levels: If the patient gets IV heparin, keep an eye on aPTT and PT levels as advised by the hospital. If they’re not right, it could lead to bleeding.
- Give antidotes if needed: Antidotes like protamine sulfate for heparin or vitamin K for warfarin might help with excessive bleeding.
- Check for medications that can raise bleeding risk: Some medications, like aspirin, NSAIDs, and anticoagulants, can make bleeding more likely.
- Give meds as told: Steroids can increase platelet count, while immunoglobulins can stop the immune system from harming platelets. Other medications can boost platelet making.
- Prepare for platelet transfusions: When platelets are very low, patients often get platelets from blood to raise the count.
- Be careful with procedures: Patients might still need IVs or shots. Remember, needles can make bleeding last longer. Press on the spot to help it clot.
Risk for Deficient Knowledge
Related to:
- Wrong information
- Not enough information
- Not trying to learn
- Not interested in learning
- Not taking part in care planning
As seen by:
- Wrongly talking about the disease
- Not following instructions correctly
- Not doing lab tests as needed
- Getting severe bleeding
Expected outcomes:
- Patients will understand the disease, what might happen, and how to treat it.
- Patients will use two ways to stop bleeding.
Assessment
- Check what the patient knows about thrombocytopenia: Understanding what the patient knows can help plan care and figure out what more they need to learn.
- Find out how the patient learns best: Info sticks better if it’s given in the way the patient learns best, like reading, seeing, or hearing it.
Intervention
- Teach the patient how to prevent bleeding: Be careful with sharp things, use electric razors instead of regular ones, brush teeth gently, avoid aspirin meds, and avoid straining too hard when using the bathroom or inserting anything rectally to prevent internal damage and bleeding.
- Tell the patient to change their lifestyle: Avoid doing risky activities like dangerous sports to cut down on the chance of bleeding problems.
- Show the patient signs of possible problems with thrombocytopenia: If they bruise easily or start bleeding for no reason, if there’s blood in their pee or poo, if their gums and nose bleed, or if they have weird nerve issues, they should tell someone quickly.
- Explain why they might need spleen surgery: Sometimes they might need to take out the spleen for ITP or if other treatments didn’t work. The spleen helps fight germs, so they’ll need to be extra careful to avoid getting sick.
Risk for Deficient Fluid Volume
Related to:
- Excessive bleeding
- Weak blood clotting
As seen by:
- A risk diagnosis means there are no symptoms yet. Nurses focus on preventing them.
Expected outcomes:
- The patient doesn’t have signs of bleeding, and has normal vital signs.
- Hemoglobin and hematocrit values will be normal.
Assessment
- Check vital signs: Changes like low blood pressure could mean bleeding or losing fluid.
- Check lab results: Low levels of hematocrit and hemoglobin in blood tests might show blood loss.
Intervention
- Keep track of what the patient drinks and pees: This helps check how much fluid the patient has and if they’re hydrated enough.
- Give more fluids if needed: Adding fluids helps blood flow better and replaces what’s lost.
- Give blood transfusions as ordered: Sometimes patients need blood like red cells, platelets, or plasma to help stop bleeding and fill up the blood supply.
- Teach the patient about bleeding signs: Losing fluid from bleeding can happen at any time. Patients need to know what to look out for and what could happen if they bleed too much.
Learn About Proper Nursing Interventions with this Care Plan
Learn about thrombocytopenia and how to prevent bleeding. Understand its causes, symptoms, and treatments. Know what to do to stay safe and healthy. Be aware of signs of bleeding and take action if they occur. Stay informed and take care of your patient properly!