NUR 148 Exam 6 Guide With
Solution
What is thrombocytopenia - ANSWER low platelet count
considerations for thrombocytopenia - ANSWER - greater risk for bleeding
due to platelets being critical for blood clotting
- 40,000-80,000: prolonged bleeding from trauma, dental work, and surgery.
- below 20,000: spontaneous bleeding that is difficult to stop
causes of thrombocytopenia - ANSWER -cytotoxic chemo
- bone marrow suppression
Idiopathic, Drug-induced (ASA, acetaminophen, streptomycin,
chemotherapy, thiazide diuretics, sulfonamides), Dev. after blood
transfusions, Hemorrhage, DIC, Decreased platelet production, Vasculitis,
Infections, Sepsis
nursing care for thrombocytopenia: pt education - ANSWER - avoid food that
scrape the mouth
- do not take aspirin- containing products unless prescribed
- do not participate in contact sports
- daily mouth and skin checks
- do not forcefully blow nose or insert objects
- avoid anal intercourse
,- take stool softener
- no tight clothing or shoes
- avoid activities that increase brain pressure
nursing care for thrombocytopenia: preventing injury - ANSWER - use
caution and a lift sheet when repositioning
- avoid IM injections
- platelets less than <50,000 procedures are postponed
- use smallest gauge needle if injections are needed and apply firm pressure
after stick
- apply ice to area of trauma
- test urine and stool for occult blood
- observe IV sites every 4 hrs
- educate pts to instruct nurse of any trauma or injuries
- do not administer enemas
- liberally lubricate suppositories
- electric shaver
- use soft bristle tooth brush
- no water pressure gum cleaner
- make sure dentures fit
, - wear proper shoes with firm soles
- keep pathways clear of clutter
what is neutropenia? - ANSWER a decreased number of neutrophil white
blood cells leading to immunosuppression
- cytotoxic chemo can cause this
pt care for neutropenia - ANSWER - place pt in a private room
- good handwashing or alcohol based sanitizer before touching the pt and
their belongings
- ensure pt room and bathroom are cleaned daily
- limit number of staff and people that enter the patients room
- vitals q4h
- inspect skin for fissures or abscess
- inspect IV sites
- change wound dressing daily or as ordered
- strict aseptic technique for all invasive procedures
- notify HCP if any infection and obtain a culture per protocol
- encourage activity at appropriate level
Solution
What is thrombocytopenia - ANSWER low platelet count
considerations for thrombocytopenia - ANSWER - greater risk for bleeding
due to platelets being critical for blood clotting
- 40,000-80,000: prolonged bleeding from trauma, dental work, and surgery.
- below 20,000: spontaneous bleeding that is difficult to stop
causes of thrombocytopenia - ANSWER -cytotoxic chemo
- bone marrow suppression
Idiopathic, Drug-induced (ASA, acetaminophen, streptomycin,
chemotherapy, thiazide diuretics, sulfonamides), Dev. after blood
transfusions, Hemorrhage, DIC, Decreased platelet production, Vasculitis,
Infections, Sepsis
nursing care for thrombocytopenia: pt education - ANSWER - avoid food that
scrape the mouth
- do not take aspirin- containing products unless prescribed
- do not participate in contact sports
- daily mouth and skin checks
- do not forcefully blow nose or insert objects
- avoid anal intercourse
,- take stool softener
- no tight clothing or shoes
- avoid activities that increase brain pressure
nursing care for thrombocytopenia: preventing injury - ANSWER - use
caution and a lift sheet when repositioning
- avoid IM injections
- platelets less than <50,000 procedures are postponed
- use smallest gauge needle if injections are needed and apply firm pressure
after stick
- apply ice to area of trauma
- test urine and stool for occult blood
- observe IV sites every 4 hrs
- educate pts to instruct nurse of any trauma or injuries
- do not administer enemas
- liberally lubricate suppositories
- electric shaver
- use soft bristle tooth brush
- no water pressure gum cleaner
- make sure dentures fit
, - wear proper shoes with firm soles
- keep pathways clear of clutter
what is neutropenia? - ANSWER a decreased number of neutrophil white
blood cells leading to immunosuppression
- cytotoxic chemo can cause this
pt care for neutropenia - ANSWER - place pt in a private room
- good handwashing or alcohol based sanitizer before touching the pt and
their belongings
- ensure pt room and bathroom are cleaned daily
- limit number of staff and people that enter the patients room
- vitals q4h
- inspect skin for fissures or abscess
- inspect IV sites
- change wound dressing daily or as ordered
- strict aseptic technique for all invasive procedures
- notify HCP if any infection and obtain a culture per protocol
- encourage activity at appropriate level
