Thrombocytopenia is when there is a low platelet count and an increased risk of bleeding. This is usually a side effect of another disease process such as leukemia and some immune system disorders, or the use of certain medications. Platelets, also called thrombocytes, are essential to the body as they clump together and form clots that seal blood vessels when injury or damage occurs. If bleeding does occur, it may be internal or external.
Many factors influence the development of thrombocytopenia such as cancers, autoimmune diseases, infections, surgery, alcohol use and certain medications. The condition can be inherited or acquired. Generally, a low platelet count develops when the bone marrow fails to produce enough thrombocytes, the bone marrow makes enough, but the body destroys them or uses them too quickly, or when the spleen holds on to too many platelets.
Increase platelet production and availability, minimize risk of excessive bleeding, treat underlying cause
** Patients may be completely asymptomatic **
Observe skin for petechiae, purpura and open wounds. Bleeding may be minimal, non-existent or severe.
NSAIDs such as ibuprofen and aspirin can increase the risk of bleeding and should be avoided. If pain relief is necessary, recommend acetaminophen or non-pharmacological alternatives.
Decreased platelet counts do not always indicate bleeding, but may lead to excessive bleeding if injury occurs.
Avoid high risk activities that may result in injury to reduce the risk of bleeding; alcohol slows the production of platelets; NSAIDs increase the likelihood of bleeding; leafy greens are high in vitamin K which helps promote clotting.
Removing the spleen may be necessary to treat thrombocytopenia. If so, it increases the risk of infection. Monitor for fever, rash and other signs of infection.
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