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NURS 5463 - Mod 3 - Platelet Disorders Exam With Complete Solutions
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NURS 5463 - Mod 3 - Platelet Disorders ExamWith Complete Solutions
Thrombocytopenia Risk of Bleeding - Answer >50,000 - Adq for hemostasis in most
cases
30-50k - rarely have purpura, even w/ significant trauma
10-30k - usually asymptomatic, increased risk for excessive bleeding w/ trauma,
spontaneous bleeding may occur but not common
<10k - spontaneous bleeds develop, petechiae present, medical emergency
*>50k indicated for invasive procedures (80-100 for surgery)
Causes of Thrombocytopenia - Answer-hemodilution (occurs post op, drop in 20-70%,
usually nadir in 2-4 days)
-Hypersplenism (platelets destroyed in the spleen)
-HIV
-Viral infections
-SLE
Medications that Cause Thrombocytopenia - Answer Sulfonamides
Quinine (tonic water)
Heparin
Eptifibatide (Integrillin)
Rifampin (Rifadin)
Beta lactam antibiotics (PCN, Cephalosporins)
Carbamazepine (Tegretol)
Levofloxacin (flouroquinolones)
, Vancomycin
Linezolid (Zyvox)
Abciximab (Reopro)
Tirofibab (Aggrastat)
Piperacillin
Valproic Acid (Depakote)
Phenytoin (Dilantin)
*antiplatelet agents*
Thrombocytopenic Emergencies - Answer Bleeding w/ platelets <50k
Urgently needed invasive procedure w/ platelets
Pregnancy w/ platelets <50k
Suspected thrombotic thrombocytopenic purpura (hematology)
Acute leukemia, aplastic anemia, or other bone marrow failure syndrome suspected
(hematology)
Thrombotic Thrombocytopenic Purpura (TTP) Answer An acute syndrome which causes
thrombocytopenia, microangiopathic hemolytic anemia and thrombosis in the
microvascular resulting in organ damage. Often presents with neurologic or renal
clinical manifestations but can affect any organ *Medical Emergency*
ADAMTS13 deficiency leads to increased von Willebrand factor and platelet
aggregation
Risk factors female gender and AA
90% mortality rate if untreated
TTP clinical presentation-Answer AMS, neuro dysfunction, fatigue w/ anemia,
microangiopathic anemia, petechiae, pallor, jaundice, dark urine from hemoglobinuria,
GI symptoms common, CP
TTP Diagnostic Eval-Answer CBC-hgb mod low (8-9), plt 20-50k, peripheral
smear-presence of schistocytes (fragmented RBCs)
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