Nursing Care Plan (NCP) for Thrombocytopenia

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Thrombocytopenia Pathochart (Cheat Sheet)
Platelet Lab Value (Picmonic)

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Example Nursing Diagnosis for Thrombocytopenia

  1. Risk for Bleeding: Thrombocytopenia increases the risk of bleeding. This diagnosis highlights the potential for bleeding events and the need for precautions.
  2. Impaired Skin Integrity: Patients with thrombocytopenia may develop petechiae or ecchymosis. This diagnosis addresses the risk of skin integrity issues.
  3. Altered Comfort: Thrombocytopenia-related bleeding can lead to discomfort and pain. This diagnosis focuses on comfort measures.


Hey guys, let's take a look at the care plan for thrombocytopenia. In this lesson, we'll briefly take a look at the pathophysiology and etiology of thrombocytopenia. We're also going to take a look at additional things that would be included in this care plan, like subjective and objective data, as well as nursing interventions and rationales. 


Thrombocytopenia is defined as a low platelet count and an increased risk of bleeding. Usually,  thrombocytopenia is a side effect of another disease process like leukemia, some immune disorders, or even medications. Thrombocytes are essential to the body because as they clump together to form clots and seal blood vessels when injury or damage occurs. If bleeding does occur, it can be internal or external. Many factors influence the development of thrombocytopenia, such as cancers, autoimmune diseases, infections, surgery, alcohol use disorder, and also certain medications. The condition can be inherited or acquired. Generally, a low platelet count develops when the bone marrow fails to produce enough thrombocytes, or the bone marrow makes enough for the body, destroys them, or uses them too quickly, or when the spleen holds on to too many platelets. The desired outcome is to increase platelet production and availability, minimize the risk of excessive bleeding and to treat that underlying cause.


Let's take a look at some of the subjective and objective data that your patient with thrombocytopenia may present with. Remember, subjective data are going to be things that are based on your patient's opinions or feelings. This might include bruising easily, or bleeding gums with brushing, although patients might even be asymptomatic or have no symptoms at all. 


Objective data includes petechiae or purpura, abnormal vaginal bleeding, epistaxis, or a platelet count on CBC of less than a hundred thousand. 


Let's take a look at the nursing interventions when caring for a patient with thrombocytopenia. Assess for signs of internal and external bleeding, including blood in the urine or stool, bleeding of the mucous membrane, such as the gums, and the skin. Observe the skin for petechiae, purpura, or open wounds. Bleeding can be minimal, it can be non-existent, or it can be severe. So, even though platelets are low, administering platelets may not be indicated if there are no signs of active bleeding. 


Treatment is going to depend on the cause of the thrombocytopenia. Immunosuppressants may be given if the underlying cause is auto-immune, Androgens may be given to males only, because of the possibility of unwanted hair growth that would occur in females. Vinca alkaloids may also be given if other measures have failed. So 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 platelets does not always indicate bleeding in the patient, but it may lead to excessive bleeding if injury occurs, so teach your patient about bleeding precautions. Patients should use only electric razors. Needle sticks should be limited. They should use a soft toothbrush and provide safety devices like non-skid shoes and socks to prevent injury. It's important to teach your patient to avoid high-risk activities that could cause injury like contact sports to reduce the risk of bleeding. 


Alcohol should be avoided, or at least limited because alcohol slows the production of platelets. Also like I mentioned earlier, NSAIDS can increase the likelihood of bleeding, so they should be avoided. increase the intake of green leafy vegetables as they are high in vitamin K, which helps to promote clotting. Finally, removing the spleen may be necessary to treat thrombocytopenia, and if this is the case, it increases the risk for infection in the patient, so teach the patient to monitor for fever, rash, and other signs of infection. 


Okay, guys, here is a look at the completed care plan for thrombocytopenia. We love you guys. Now, go out and be your best self today and as always, happy nursing!

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