A nurse is caring for a patient with thrombocytopenia.
The patient presents with mucosal bleeding, including petechiae, purpura, and gingival bleeding.
What should the nurse anticipate when assessing this patient’s platelet count?
A.
The platelet count is likely within the normal range.
B.
The platelet count may be below 50,000/uL, indicating a risk of prolonged bleeding.
C.
The platelet count is typically above 100,000/uL in thrombocytopenia.
D.
The platelet count does not affect bleeding symptoms.
The Correct answer and Explanation is:
The correct answer is B. The platelet count may be below 50,000/uL, indicating a risk of prolonged bleeding.
Explanation:
Thrombocytopenia is a condition characterized by a low platelet count in the blood. Platelets, or thrombocytes, are essential for blood clotting. They help form blood clots by sticking to the blood vessel walls and to each other, thereby stopping bleeding when a vessel is injured. When the platelet count drops significantly, it can lead to increased bleeding tendencies and difficulty in controlling bleeding.
In patients with thrombocytopenia, the platelet count can drop below the normal range, which is typically 150,000 to 450,000 platelets per microliter of blood. Option B is accurate because a platelet count below 50,000/uL is considered severe thrombocytopenia and is associated with a higher risk of bleeding complications. At this level, the patient is at significant risk for both spontaneous bleeding and bleeding in response to minor trauma.
Option A is incorrect because a normal platelet count would not be consistent with thrombocytopenia. If the platelet count were within the normal range, it would not explain the presence of mucosal bleeding symptoms such as petechiae, purpura, and gingival bleeding.
Option C is also incorrect. In thrombocytopenia, platelet counts are typically below 100,000/uL, not above. A platelet count above 100,000/uL would generally not be associated with severe bleeding symptoms, although it is worth noting that bleeding can still occur at counts above this level if the drop is sudden or if other underlying conditions are present.
Option D is incorrect because the platelet count directly affects bleeding symptoms. A lower platelet count impairs the blood’s ability to clot, increasing the risk and severity of bleeding.
In summary, in patients with thrombocytopenia, the platelet count is often markedly reduced, and a count below 50,000/uL significantly increases the risk of prolonged and spontaneous bleeding. This correlation is critical for nurses and healthcare providers to monitor and manage to prevent complications associated with bleeding disorders.