Sudden onset of petechiae and ecchymoses or bleeding into mucous membranes (GI, urinary, vaginal, or respiratory)
Malaise, fatigue, and general weakness, with or without accompanying blood loss
In acquired thrombocytopenia, possible use of one or several offending drugs, such as chemotherapy, chloramphenicol, gold salts, or thiazide diuretics
Administer prescribed medications. Give predniSONE orally as ordered, tapering dose.
If the patient experiences bleeding, administer a platelet transfusion as ordered.
Ensure patent I.V. access if I.V. immune globulin or a platelet transfusion is ordered.
Institute safety precautions to reduce the risk of injury.
Institute bleeding precautions. Protect all areas with petechiae and ecchymoses from further injury, and minimize invasive procedures.
If the patient is menstruating, perform a pad count.
Check urine, stool, and emesis for frank or occult bleeding.
Adhere to standard precautions and perform meticulous hand hygiene to minimize infection risk.
Encourage the patient to verbalize feelings related to the condition.
Provide emotional support, and help the patient develop positive coping strategies, emphasizing positive aspects of his status.
Encourage patient participation in activities and decision making to foster feelings of self-esteem and control.
Urge the use of energy-conservation techniques; cluster nursing activities to provide for rest periods.
Obtain specimens for laboratory testing to evaluate platelet levels and response to treatment. Apply firm, direct pressure to injection sites used for specimen collection.
Provide a stool softener if necessary.
During active bleeding, maintain strict bed rest and keep the head of the bed elevated.
Prepare the patient for possible splenectomy, as appropriate. Provide postoperative care after splenectomy.
disorder, its cause, if known, and, if appropriate, the fact that thrombocytopenia commonly resolves spontaneously
possible treatment, including medication therapy and platelet transfusions
signs and symptoms of intracranial bleeding and other bleeding and the need to immediately contact a health care provider if any occurs
ways to minimize the risk of bleeding, including avoidance of contact sports and activities as appropriate
importance of monitoring for petechiae and ecchymoses and measures to control local bleeding
signs and symptoms of bleeding, including bleeding from the gums, nose, and GI tract
bleeding precautions and the use of direct, steady pressure at a bleeding site if bleeding develops
need to check with a practitioner before using any over-the-counter products that may contain aspirin or ibuprofen, which could increase the risk of bleeding
importance of avoiding straining during defecation and coughing
use of stool softeners
proper technique for testing stools for occult blood
prescribed medication therapy regimen, such as predniSONE, including the need to take the drug exactly as prescribed and the importance of tapering the dose
adverse reactions associated with drug therapy, such as cushingoid effects
importance of avoiding the offending drug in drug-induced thrombocytopenia
use of a humidifier at night if the patient experiences frequent nosebleeds
need to carry medical identification to alert others about the condition
importance of follow-up care, including periodic laboratory testing of platelet levels (frequency depends on the severity of the disorder and on the treatment plan).