A nurse is caring for a patient with thrombocytopenia.
Which statement accurately describes the pathophysiology of immune thrombocytopenic purpura (ITP)?
"ITP results from decreased platelet production in the bone marrow.”
"In ITP, autoantibodies mark platelets for destruction by macrophages.”
"ITP is characterized by impaired cleavage of von Willebrand factor.”
"Thrombocytopenia in ITP is triggered by heparin-platelet factor 4 complexes.”
The Correct Answer is B
Choice A rationale:
"ITP results from decreased platelet production in the bone marrow." Rationale: This statement is not accurate.
Immune Thrombocytopenic Purpura (ITP) is primarily a disorder of platelet destruction, not decreased production in the bone marrow.
In ITP, autoantibodies target platelets, leading to their destruction by macrophages.
Choice B rationale:
"In ITP, autoantibodies mark platelets for destruction by macrophages." Rationale: This is the correct answer.
ITP is an autoimmune disorder where the immune system produces autoantibodies that attach to platelets, tagging them for destruction by macrophages in the spleen and liver.
Choice C rationale:
"ITP is characterized by impaired cleavage of von Willebrand factor." Rationale: This statement is not accurate.
Impaired cleavage of von Willebrand factor is a characteristic of von Willebrand disease, a different bleeding disorder, not ITP.
Choice D rationale:
"Thrombocytopenia in ITP is triggered by heparin-platelet factor 4 complexes." Rationale: This statement is incorrect.
Heparin-induced thrombocytopenia (HIT) involves the formation of antibodies against heparin-platelet factor 4 complexes, leading to platelet activation and a decrease in platelet count.
This is a different condition than ITP.
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Related Questions
Correct Answer is ["B","C","D"]
Explanation
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.
Correct Answer is B
Explanation
Choice A rationale:
Encourage the patient to consume NSAIDs for pain relief.
Encouraging the use of NSAIDs for pain relief is not appropriate for patients with thrombocytopenia.
NSAIDs can further increase the risk of bleeding due to their antiplatelet effects.
Therefore, it is crucial to educate patients to avoid NSAIDs.
Choice B rationale:
Teach the patient to avoid alcohol and aspirin.
This is a crucial part of patient education for those with thrombocytopenia.
Alcohol and aspirin can both increase the risk of bleeding, so advising patients to avoid them is essential to minimize bleeding risks.
Choice C rationale:
Suggest regular injections to stimulate platelet production.
While there are treatments available to stimulate platelet production, they are typically prescribed by a healthcare provider based on the patient's specific diagnosis and medical needs.
Suggesting regular injections without medical guidance is not appropriate.
Choice D rationale:
Advise the patient to skip monitoring platelet counts.
Regular monitoring of platelet counts is essential for patients with thrombocytopenia to assess the effectiveness of treatment and identify any potential complications.
Advising the patient to skip monitoring is not appropriate and may lead to undetected issues.
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