NUR 252 HEME NEURO EXAM
STUDY GUIDE
,NUR 252 Heme Neuro Exam Study
Guide
Nursing Theory and Science III (Phoenix
College)
,Thrombocytopenia
Description: Low platelets, <150,000
- Reduced platelet production in the bone marrow
- ↑ destruction of platelets
- ↑ consumption of platelets (used up for clot formation)
Types
- Idiopathic: spontaneous disease process
- HIT: Heparin-induced thrombocytopenia
- Bleeding & petechiae (risk for excessive bleeding after surgery/trauma)
- Rarely occurs with platelet count >50,000
- Platelet count <20,000
- Petechiae
- Nasal, gingival bleeding
- Excessive menstrual bleeding
- Excessive bleeding from surgery or dental work
- Platelet count <5000
- Spontaneous and fatal bleeding in the CNS or GI tract
*If abnormal platelet function is a result of disease (myelodysplastic syndrome (MDS):
bone marrow produces abnormal & insufficient blood cells) or meds (aspirin), risk of
bleeding is greater even when the platelet count is slightly reduced
Assessment & Diagnostics
- Bone marrow aspiration & biopsy
- Identify platelet deficiency: ↓ production
- Findings:
- ↓ Megakaryocytes = impaired production
- ↑ Megakaryocytes w/ normal/increased platelet production =
suggests increased destruction (body is trying to compensate
for decreased platelets in the circulation by making more)
- Genetics
- Autosomal dominant
- Autosomal recessive
- X-linked mutations
- Viral screening
- Hep B & C can cause thrombocytopenia
- R/O Pseudothrombocytopenia
- False low platelet count d/t platelet
clumping in EDTA anticoagulant tube for
CBC collection
- Occurrence: ~0.8% to 1.25% of the population
- Detection:
- Peripheral smear shows clumping
- Confirmatory Test: Redraw blood in
a citrate tube instead of EDTA and
analyze rapidly for accurate
platelet count
, Medical Mgmt
- Secondary Thrombocytopenia
- Tx underlying cause
- Platelet transfusion if platelet production is
impaired -> to increase platelet count & stop
bleeding or prevent spontaneous hemorrhage
- If excessive platelet destruction occurs,
transfused platelets can be destroyed
too
- Most common cause of increased
platelet destruction: Immune
thrombocytopenic purpura (ITP)
- Immune system mistakenly attacks platelets -> leads to low
STUDY GUIDE
,NUR 252 Heme Neuro Exam Study
Guide
Nursing Theory and Science III (Phoenix
College)
,Thrombocytopenia
Description: Low platelets, <150,000
- Reduced platelet production in the bone marrow
- ↑ destruction of platelets
- ↑ consumption of platelets (used up for clot formation)
Types
- Idiopathic: spontaneous disease process
- HIT: Heparin-induced thrombocytopenia
- Bleeding & petechiae (risk for excessive bleeding after surgery/trauma)
- Rarely occurs with platelet count >50,000
- Platelet count <20,000
- Petechiae
- Nasal, gingival bleeding
- Excessive menstrual bleeding
- Excessive bleeding from surgery or dental work
- Platelet count <5000
- Spontaneous and fatal bleeding in the CNS or GI tract
*If abnormal platelet function is a result of disease (myelodysplastic syndrome (MDS):
bone marrow produces abnormal & insufficient blood cells) or meds (aspirin), risk of
bleeding is greater even when the platelet count is slightly reduced
Assessment & Diagnostics
- Bone marrow aspiration & biopsy
- Identify platelet deficiency: ↓ production
- Findings:
- ↓ Megakaryocytes = impaired production
- ↑ Megakaryocytes w/ normal/increased platelet production =
suggests increased destruction (body is trying to compensate
for decreased platelets in the circulation by making more)
- Genetics
- Autosomal dominant
- Autosomal recessive
- X-linked mutations
- Viral screening
- Hep B & C can cause thrombocytopenia
- R/O Pseudothrombocytopenia
- False low platelet count d/t platelet
clumping in EDTA anticoagulant tube for
CBC collection
- Occurrence: ~0.8% to 1.25% of the population
- Detection:
- Peripheral smear shows clumping
- Confirmatory Test: Redraw blood in
a citrate tube instead of EDTA and
analyze rapidly for accurate
platelet count
, Medical Mgmt
- Secondary Thrombocytopenia
- Tx underlying cause
- Platelet transfusion if platelet production is
impaired -> to increase platelet count & stop
bleeding or prevent spontaneous hemorrhage
- If excessive platelet destruction occurs,
transfused platelets can be destroyed
too
- Most common cause of increased
platelet destruction: Immune
thrombocytopenic purpura (ITP)
- Immune system mistakenly attacks platelets -> leads to low
