Thrombocytopenia management during chemotherapy

Thrombocytopenia

The thrombocytes or platelets are crucial for maintaining vascular integrity and hemostasis by aggregating to each other to create a clot. A reduction in the quantity of platelets to under 50,000/mm 3 indicates thrombocytopenia, which might result in bleeding.

The sites of bleeding would be the skin, mucous membranes, the GI system, the genitourinary system, the respiratory system, and also the intracranial area. The start of thrombocytopenia is slower than that of leukopenia. Chemotherapy can depress the platelet count, and drugs containing acetylsalicylic acid, other styles of salicylates, or nonsteroidal anti-inflammatory agents can potentiate existing thrombocytopenia.

Monitor the platelet count closely. Assess for superficial or internal manifestations of bleeding for example petechiae, epistaxis, easy bruising, prolonged bleeding time, "coffee-grounds" emesis, and hematuria. Test the stool for occult blood and appearance the urine for heme. Teach the individual to see the following precautions:

Conserve a safe environment to avoid falls or trauma. Use stool softeners to prevent straining, which could cause rectal tearing and bleeding. Avoid performing the Valsalva maneuver when moving or defecating. Consume a high-fiber diet and drink lots of fluids to prevent constipation. Postpone or minimize, if appropriate, any invasive medical or surgical treatments.

Don't use sharp instruments for grooming. Make use of an electric shaver. Avoid medications that might prolong or exacerbate bleeding, for example steroids and over-the-counter medications containing aspirin. If these medications are essential, the individual should take antacids, H 2 blockers, or food concomitantly.

Make use of a soft toothbrush; avoid flossing. Make use of a water-soluble lubricant for intercourse. Avoid intercourse when platelet count is under 50,000/mm3. Administer platelet transfusions as ordered. Check institutional insurance policy for transfusion parameters. Premedicate the individual and monitor for platelet reaction.

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