Idiopathic thrombocytopenic purpura involves the lysis of platelets after binding to antiplatelet autoantibodies. Compensatory production of platelets in the bone marrow occurs following this. Its acute form is mostly self-limiting, but chronic forms may last.
- Clinical Manifestations: mostly asymptomatic; easy bruising, petechiae, purpura, heavy menses and mucosal bleeding, thrombocytopenia
- Diagnostics: Decreased platelet count, increased bleeding time, and increased megakaryocyte (immature thrombocyte) counts in a bone marrow aspiration procedure.
- Medical Management: maintenance of a safe platelet count. Platelet infusions are avoided, as they will simply be destroyed. It is only used for cases of catastrophic bleeding.
- A splenectomy may be done (the spleen being the producer of the antiplatelet autoantibody and site of destruction). Unsure, but has been shown to work in 85% of patients.
- Pharmacologic Therapy: Immunosuppressants are the treatment of choice. Bone disease should be monitored for patients on long-term management. Supplementation of Calcium and Vitamin D may be beneficial.
- Nursing Interventions:
- Bleeding: risk assessment based on lifestyle, medications being taken, and physical assessment for sites of bleeding. Assess neurologic signs for bleeding.
- Teach the patient to avoid vigorous sexual activity when platelet count is below 10k/mm³.