A 24-year-old male presented to the emergency department with high fever, chills, nausea and was diagnosed with dengue fever and thrombocytopenia. His platelet count was monitored and gradually improved with corticosteroid therapy, antibiotics and remained asymptomatic. Thrombocytopenia is a low platelet count condition that can be caused by bone marrow disorders, medications, infections and other factors. Nursing management of thrombocytopenia focuses on monitoring for bleeding, educating patients, administering medications and transfusions, and preventing injuries through safety precautions.

1. MS.SUMATHI
RK WING

2. CASESTUDY
• CASE STUDY :DENGUE FEVER WITH
THROMBOCYTOPENIA in a 24 years old male
Patient presentation
• Mr. Abhiyash 24 years old male ,presents to the emergency department
with complaints of high grade fever associated with chills and h/o nausea,
not relieved after taking medication. Admitted under Dr. Mithil sir further
medical management in RK WING on17-3-2024 at 7:40pm
• Mr. Abhiyash is not having past medical and surgical history.
 Clinical examination
• Vital signs :stable
• Physical examination: On physical examination there is no symptoms
• Sent the necessary samples as per doctor advise.

3.  Follow up :
• Mr abhiyash under went necessary investigations
• Sent the blood samples as per doctor advise.
• He was experience a gradual improvement in platelet counts with
corticosteroids therapy, antibiotics and remains asymptomatic for
bleeding complications, and fever.

4. OBJECTIVES
Introduction
Definition
Causes
Symptoms
Pathophysiology
Management
Nursing Management
Conclusion

5. Definition
A condition in which there is a lower-than-
normal number of platelets in the blood.

6. THROMBOCYTOPENIA
Thrombocytopenia is a condition that occurs
when the platelet count in the blood is too low.
Platelets are tiny blood cells that are made in
the bone marrow from larger cells.
When injured, platelets stick together to form a
plug to seal the wound. This plug is called a
blood clot. Platelets are also called
thrombocytes, because a blood clot is also
called a thrombus.

7. CAUSES
There are numerous potential causes of thrombocytopenia, including:
• Immune System Disorders: Sometimes, the immune system
mistakenly attacks and destroys platelets, leading to
thrombocytopenia. This can be caused by conditions such as
immune thrombocytopenic purpura (ITP) or autoimmune diseases
like lupus.
• Bone Marrow Problems: Platelets are produced in the bone
marrow. Conditions that affect the bone marrow, such as leukemia,
myelodysplastic syndromes, or aplastic anemia, can lead to
decreased platelet production and thrombocytopenia.
• Medications: Certain medications can cause thrombocytopenia as a
side effect. These may include some antibiotics, diuretics,
chemotherapy drugs, and others.

8. Conti...
• Viral Infections: Some viral infections, such as HIV, hepatitis C, or Epstein-
Barr virus, can lead to thrombocytopenia.
• Nutritional Deficiencies: Deficiencies in certain vitamins or minerals,
particularly vitamin B12, folate, or iron, can affect platelet production and
lead to thrombocytopenia.
• Alcohol Abuse: Chronic alcohol consumption can suppress the production
of platelets in the bone marrow, leading to thrombocytopenia.
• Inherited Disorders: Certain genetic conditions, such as Wiskott-Aldrich
syndrome or May-Hegglin anomaly, can cause thrombocytopenia.
• Heparin-Induced Thrombocytopenia (HIT): Heparin, a blood thinner, can
sometimes cause an immune reaction that leads to a drop in platelet
count.
• Pregnancy: Some pregnant women may develop a condition called
gestational thrombocytopenia, where their platelet count drops
temporarily during pregnancy.

9. symptoms
 Excessive bruising
 Petechiae
 Purpura
 Nose bleeds
 Gum bleeds
 Haematuria or Malena
 Heavy menstrual periods
 Prolonged bleeding from cuts
 Blood in vomit or cough
 Fatigue

11. Bleeding Purpura

12. Pathophysiology
The pathophysiology of thrombocytopenia involves a disruption in the
production, survival, or function of platelets, leading to a decreased
platelet count in the blood. Here's an overview of the key
mechanisms involved:
1. DECREASED PRODUCTION:
 Bone Marrow Disorders: Conditions such as aplastic anemia,
myelodysplastic syndromes, and leukemia can impair the production
of platelets in the bone marrow.
 Nutritional Deficiencies: Inadequate intake of nutrients essential for
platelet production, such as vitamin B12 and folate, can lead to
thrombocytopenia.
 Chemotherapy and Radiation: Cancer treatments can suppress bone
marrow function, resulting in decreased platelet production

13. 2.INCREASED DESTRUCTION:
 Immune Thrombocytopenia (ITP): Autoimmune
destruction of platelets by antibodies, typically against
glycoprotein's on the platelet surface, leading to their
premature removal by the spleen.
 Drug-Induced Thrombocytopenia: Certain medications,
such as heparin, quinine, and some antibiotics, can induce
an immune response resulting in platelet destruction.
 Infections: Viral infections like HIV, hepatitis C, and
Epstein-Barr virus can cause immune-mediated
destruction of platelets.
 Disseminated Intravascular Coagulation (DIC):
Widespread activation of coagulation pathways in
conditions such as sepsis, trauma, or obstetric
complications can lead to consumption of platelets and
subsequer bocytopenia.

14.  Coagulation (DIC): Widespread activation of coagulation pathways in
conditions such as sepsis, trauma, or obstetric complications can lead to
consumption of platelets and subsequent thrombocytopenia.
3.Sequestration:
 Enlarged Spleen (Splenomegaly): Conditions like cirrhosis, certain cancers,
and hematologic disorders can cause an enlarged spleen, leading to
sequestration and destruction of platelets.
4.Altered Platelet Function:
 Thrombocytopathies: Inherited or acquired disorders affecting platelet
function can result in impaired platelet aggregation and adhesion, leading to
a bleeding tendency despite a normal platelet count.
 Understanding these underlying mechanisms is crucial for diagnosing and
managing thrombocytopenia effectively, as treatment approaches may vary
depending on the specific cause and pathophysiological processes involved.

16. DIAGNOSIS
• Physical examined.
• Blood Tests will be done to confirm the problem as well. These may
include:
• A complete blood cell count (CBC): This test measures the
amounts of the different types of cells in the blood. This includes the
number of platelets in the blood platelet count).
• A blood smear: This test checks for the different types of blood
cells in the blood and how they appear. A sample of blood is spread
on a glass slide and viewed under a microscope. A stain is used so
the blood cells can be seen.
• A bone marrow aspiration and biopsy: This test checks for
problems with how the bone marrow makes blood cells. A needle is
used to remove a sample of the bone marrow in hipbone. The
sample is then sent to a lab to be tested for problems.

17. MANAGEMENT
Treatment of the underlying cause: For
instance, if a medicine is the cause, it may be
stopped or changed.
Platelet transfusions: These help raise the
number of healthy platelets in the body.
Blood transfusions: These help treat blood
loss that may because of low platelets.
Medicines: These may be given to help
prevent platelets from being destroyed.
These may also be given to help the bone
marrow make more platelets.

18. NURSINGMANAGEMENT
• Nursing management in thrombocytopenia involves several key
aspects aimed at monitoring, preventing complications, and
providing supportive care for patients with low platelet counts.
Thrombocytopenia is a condition characterized by a decreased
number of platelets in the blood, which can lead to an increased
risk of bleeding. Here are some essential components of nursing
management for thrombocytopenia:
• Assessment and Monitoring: Nurses play a crucial role in assessing
and monitoring patients with thrombocytopenia. This includes
regular assessments of platelet counts, signs of bleeding (e.g.,
petechiae, bruising, bleeding gums), and other symptoms such as
fatigue and weakness. Monitoring vital signs and assessing for any
changes in the patient's condition are also important.

19. Cont...
• Education: Nurses should educate patients and their families about
thrombocytopenia, its causes, signs, and symptoms, as well as strategies
to prevent bleeding. This includes advising patients to avoid activities that
may increase the risk of injury or bleeding, such as contact sports, certain
medications (e.g., NSAIDs), and activities that can cause trauma.
• Safety Precautions: Implementing safety precautions is essential to
prevent injuries and bleeding in patients with thrombocytopenia. This may
include using soft-bristled toothbrushes, avoiding intramuscular
injections, and ensuring a safe environment to prevent falls.
• Medication Management: Nurses are responsible for administering
medications as prescribed by the healthcare provider to manage
thrombocytopenia. This may include medications to stimulate platelet
production (e.g., thrombopoietin receptor agonists) or to prevent bleeding
(e.g., platelet transfusions, antifibrinolytic agents).

20. Cont....
• Transfusion Management: If platelet transfusions are required to manage severe
thrombocytopenia or to control bleeding, nurses play a critical role in administering
transfusions safely and monitoring the patient for any adverse reactions.
• Wound Care: Nurses should provide meticulous wound care to patients with
thrombocytopenia to prevent infection and promote healing. This includes assessing wounds
for signs of bleeding or infection, applying appropriate dressings, and monitoring for any
changes in the wound's condition.
• Psychosocial Support: Living with thrombocytopenia can be challenging for patients and
their families. Nurses should provide emotional support, address concerns, and connect
patients with appropriate resources such as support groups or counseling services.
• Collaboration and Communication: Effective communication and collaboration with the
healthcare team, including physicians, pharmacists, and other allied healthcare professionals,
are essential for providing comprehensive care to patients with thrombocytopenia. This
includes sharing relevant information about the patient's condition, treatment plan, and any
changes in their status.
By focusing on these key aspects of nursing management, nurses can help optimize care and i
mprove outcomes for patients with thrombocytopenia.

21. Conclusion:
• Conclusion:
• This case highlights the clinical presentation,
diagnostic approach, and management of
thrombocytopenia in an adult patient.
• Here we seen introduction, definition,
Symptoms, Causes, Pathophysiology, medical
Management and nursing management.
•

22. SUMATHI.P