The nurse would question which therapy that is listed on a treatment plan for a patient who has TTP

Diagnosis

The following can be used to determine whether you have thrombocytopenia:

  • Blood test. A complete blood count determines the number of blood cells, including platelets, in a sample of your blood.
  • Physical exam, including a complete medical history. Your doctor will look for signs of bleeding under your skin and feel your abdomen to see if your spleen is enlarged. He or she will also ask you about illnesses you've had and the types of medications and supplements you've recently taken.

Your doctor might suggest other tests and procedures to determine the cause of your condition, depending on your signs and symptoms.

Treatment

Thrombocytopenia can last for days or years. People with mild thrombocytopenia might not need treatment. For people who do need treatment for thrombocytopenia, treatment depends on its cause and how severe it is.

If your thrombocytopenia is caused by an underlying condition or a medication, addressing that cause might cure it. For example, if you have heparin-induced thrombocytopenia, your doctor can prescribe a different blood-thinning drug.

Other treatments might involve:

  • Blood or platelet transfusions. If your platelet level becomes too low, your doctor can replace lost blood with transfusions of packed red blood cells or platelets.
  • Medications. If your condition is related to an immune system problem, your doctor might prescribe drugs to boost your platelet count. The first-choice drug might be a corticosteroid. If that doesn't work, stronger medications can be used to suppress your immune system.
  • Surgery. If other treatments don't help, your doctor might recommend surgery to remove your spleen (splenectomy).
  • Plasma exchange. Thrombotic thrombocytopenic purpura can result in a medical emergency requiring plasma exchange.

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Lifestyle and home remedies

If you have thrombocytopenia, try to:

  • Avoid activities that could cause injury. Ask your doctor which activities are safe for you. Contact sports, such as boxing, martial arts and football, carry a high risk of injury.
  • Drink alcohol in moderation, if at all. Alcohol slows the production of platelets in your body. Ask your doctor whether it's OK for you to drink alcohol.
  • Use caution with over-the-counter medications. Over-the-counter pain medications, such as aspirin and ibuprofen (Advil, Motrin IB, others) can prevent platelets from working properly.

Preparing for your appointment

Start by seeing your primary care doctor, who can manage most cases of thrombocytopenia. In certain situations, he or she might refer you to a specialist in blood diseases (hematologist).

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.

Make a list of:

  • Warning signs you've noticed, such as any unusual bruising or bleeding or any rashes, and when they began
  • Key personal information, including recent illnesses or medical procedures such as a blood transfusion, major stresses or recent life changes
  • All medications, vitamins and other supplements you take, including doses
  • Questions to ask your doctor

Take along a family member or friend, if possible, to help you remember the information you receive.

For thrombocytopenia, questions to ask your doctor include:

  • How many platelets do I have in my blood?
  • Is my platelet count dangerously low?
  • What is causing my thrombocytopenia?
  • Do I need more tests?
  • Is my condition likely temporary or chronic?
  • What are my treatment options?
  • What will happen if I do nothing?
  • Are there any restrictions that I need to follow?
  • Are there printed materials I can have? What websites do you recommend?

April 19, 2022

  1. Thrombocytopenia and platelet dysfunction. The Merck Manual Professional Edition. http://www.merckmanuals.com. Accessed Feb. 20, 2015.
  2. George JN, et al. Approach to the adult with unexplained thrombocytopenia. http://www.uptodate.com/home. Accessed Feb. 18, 2015.
  3. AskMayoExpert. Thrombocytopenia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  4. Thrombocytopenia. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/book/export/html/4876. Accessed Feb. 23, 2015.
  5. AskMayoExpert. Hemolytic uremic syndrome (HUS) (Adult and pediatric). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
  6. E. coli. U.S. Food and Drug Administration. www.foodsafety.gov. Accessed Feb. 23, 2015.
  7. AskMayoExpert. Immune thrombocytopenia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.

Related

Associated Procedures

Products & Services

What is the treatment for thrombotic thrombocytopenic purpura?

Therapeutic plasma exchange (plasmapheresis) is used to treat acquired TTP. In this procedure, the liquid part of your blood (plasma) is replaced with donor plasma, using a machine that collects the cells in the blood. It removes antibodies (proteins) in your blood that damage your ADAMTS13 enzyme.

Which assessment findings indicate that a patient may be experiencing TTP?

Complete blood count (CBC) findings in patients with thrombotic thrombocytopenic purpura (TTP) are usually as follows: Total white blood cell count is normal or slightly elevated. Hemoglobin concentration is moderately depressed at 8-9 g/dL. Platelet count generally ranges from 20,000-50,000/μL.

Which drug is likely cause of thrombocytopenia?

Heparin, a blood thinner, is the most common cause of drug-induced immune thrombocytopenia. If a medicine prevents your bone marrow from making enough platelets, the condition is called drug-induced nonimmune thrombocytopenia.

Which nursing intervention would be appropriate in the care of a patient diagnosed with ITP?

Life-threatening bleeding requires conventional critical care interventions; in the patient with known ITP, high-dose parenteral glucocorticoids and IV immunoglobulin (IVIg), with or without platelet transfusions, are appropriate.