Immune thrombocytopenia (ITP) | Episode 026


Episode summary introduction:

What is ITP?

ITP is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Topic 1:

ITP is diagnosed by lab testing, physical exam and exclusion of other possible causes of bleeding and a low platelet count.

  • Isolated thrombocytopenia on a complete blood cell count (CBC) is the key laboratory finding; the white blood cell (WBC) count and hemoglobin level typically are normal, unless severe hemorrhage has occurred; on peripheral smear, truly giant platelets suggest congenital thrombocytopenia.

Rarely, adults might need a bone marrow exam to rule out other problems.

Topic 2:

Some treatments are simple, just lab monitoring. At present, most treatment protocols concentrate on the reduction of platelet destruction, and the drugs used are usually immunosuppressives.

Topic 3:

Nursing considerations:

Nursing care focuses on the ABCs, which include providing oxygen, controlling severe hemorrhage, and initiating IV fluids to maintain hemodynamic stability; airway control may be necessary for a large intracranial hemorrhage.

Address risk factors for increased bleeding, such as GI disease, CNS disease, urologic disease, or active lifestyle, as these may determine the aggressiveness of management.

Patient’s need to be diligent to prevent bleeding, injury and infections.

Outro:

Although there are about 50 children and 66 adults cases per 1,000,000 of Immune thrombocytopenia dx-ed each year, it is important to bring awareness to this illness. As nurses, we need to continually educate ourselves in order to provide appropriate patient care, patient education and advocacy.

References:

https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325

https://www.nhlbi.nih.gov/health-topics/immune-thrombocytopenia

https://www.hopkinsmedicine.org/health/conditions-and-diseases/idiopathic-thrombocytopenic-purpura

https://rarediseases.org/rare-diseases/immune-thrombocytopenia/#:~:text=The%20incidence%20(how%20many%20people,is%209.5%20cases%20per%20100%2C000.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3448244/

https://nurseslabs.com/idiopathic-thrombocytopenic-purpura/https://www.webmd.com/a-to-z-guides/idiopathic-thrombocytopenic-purpura

https://www.pdsa.org/newly-diagnosed.html

https://pdsa.org/about-itp/living-with-itp.html

Call to action:

Support website:

https://www.pdsa.org/support-groups.html

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