A client has developed thrombocytopenia following chemotherapy.
What is the likely cause of thrombocytopenia in this patient?

Confusion.

C. Swelling of affected limbs.

D. Blood in stool (hematochezia)

Choice A rationale:

Fever.

Rationale: Fever is not typically associated with thrombocytopenia itself.

Thrombocytopenia primarily affects the platelet count and can result in bleeding symptoms, but fever is not a direct symptom of thrombocytopenia.

Choice B rationale:

Confusion.

Rationale: Confusion can be a symptom of thrombocytopenia, especially if bleeding occurs in the brain, leading to neurological symptoms.

Thrombocytopenia can cause intracranial bleeding, which may result in confusion and altered mental status.

Choice C rationale:

Swelling of affected limbs.

Rationale: Swelling of affected limbs is not a common symptom of thrombocytopenia.

Thrombocytopenia primarily leads to bleeding symptoms, such as easy bruising, petechiae, or hematomas, rather than swelling.

Choice D rationale:

Blood in stool (hematochezia)

Rationale: Blood in stool (hematochezia) is a potential symptom of thrombocytopenia.

When platelet counts are low, it can lead to gastrointestinal bleeding, which may manifest as blood in the stool.

Choice E rationale:

Elevated liver function tests (ALT and AST)

Rationale: Elevated liver function tests (ALT and AST) are not typically associated with thrombocytopenia.

Thrombocytopenia is primarily related to platelet counts, while elevated liver function tests suggest liver dysfunction, which may have different causes.

Choice A rationale:

Administer platelet transfusions for life-threatening hemorrhage.

Platelet transfusions are typically administered in cases of severe thrombocytopenia where the risk of life-threatening hemorrhage is high.

However, it is not appropriate to administer platelet transfusions routinely or without a specific indication.

Therefore, this choice is not applicable in all cases of thrombocytopenia.

Choice B rationale:

Discontinue heparin immediately if signs of thrombosis are present.

In patients with thrombocytopenia, the use of heparin can increase the risk of bleeding.

If signs of thrombosis (clot formation) occur while a patient is on heparin, it is crucial to discontinue the medication promptly to prevent further clot formation.

This is a necessary intervention in such cases.

Choice C rationale:

Teach the patient to avoid NSAIDs, aspirin, and alcohol.

Patients with thrombocytopenia have a reduced number of platelets, which are essential for blood clotting.

NSAIDs (nonsteroidal anti-inflammatory drugs), aspirin, and alcohol can further increase the risk of bleeding by interfering with platelet function or causing irritation to the gastrointestinal tract.

Therefore, it is essential to educate patients to avoid these substances to minimize bleeding risks.

Choice D rationale:

Administer corticosteroids, IVIG, anti-D antibody, or rituximab as prescribed.

These treatments may be prescribed in specific cases of thrombocytopenia, depending on the underlying cause.

Corticosteroids can help reduce immune-mediated destruction of platelets, IVIG (intravenous immunoglobulin) can boost platelet levels, anti-D antibody is used in Rh-positive individuals with Rh-negative platelets, and rituximab may be prescribed for certain autoimmune causes of thrombocytopenia.

The administration of these medications is based on the patient's specific diagnosis and medical orders.

Choice E rationale:

Monitor the patient's response to treatment by checking the skin color and temperature.

While monitoring the patient's response to treatment is essential, checking skin color and temperature alone may not provide comprehensive information about thrombocytopenia management.

Monitoring platelet counts, signs of bleeding, and other relevant laboratory parameters would be more specific and valuable in assessing the effectiveness of treatment.