Precautions for Inpatients With Low Platelet Count

A low blood platelet count can be a dangerous situation. Platelets play a role in blood clotting. When the blood does not clot properly, excessive bleeding can occur. There are many risks to consider and precautions to take when dealing with inpatients who have low platelet counts. Treatment plans can be hindered by low platelet counts.

Symptoms

• Thrombocytopenia is the medical term for low platelet count. It is a potentially dangerous condition that can cause several problems. Common problems related to low platelet count are easy or excessive bruising and superficial bleeding into the skin. This will usually appear as a rash with pinpoint-sized reddish or purple spots, which usually appears on the lower legs. Other symptoms are prolonged bleeding from cuts and wounds, spontaneous bleeding that stems from your gums or nose, visible blood in your urine or stools, unusually heavy menstrual cycles, and extreme bleeding during surgery.

  Precautions are needed for patients in a hospital environment when dealing with low platelet counts. Injections should be given carefully, watching for excessive bleeding, and fall precaution notifications should be present on the patient's chart. Bed baths should be given gently, so as not to tear the skin or cause bruising; toe nails and finger nails should be clipped by a nurse or medical professional; and medications that can lower platelet counts should be avoided.

Surgery

• Surgery can be a dangerous procedure for someone with low platelet counts. Because surgery causes a loss of blood, you can get into dangerous situations with excessive bleeding and lack of clotting factors. In some cases, bleeding to death can be the outcome.

  In certain situations, there may be a temporary treatment so you can proceed with your surgery. Platelet concentrates can be given to help raise your platelet count, but this is only a temporary solution. Typically, platelet concentrations would be given when low counts are due to chemotherapy or to help prevent bleeding during a surgery. Giving routine platelet transfusions may be limited due to the formation of antibodies which are capable of destroying new platelets.

Blood Tests and Medication

• If you have a low platelet count, regular testing of your blood may be needed while you are in the hospital to make sure your level isn't dropping. According to Dr. David Steensma of the hematology department at Mayo Clinic, if your platelet count is below 70,000, your doctor may request that you discontinue using blood thinners.

  If blood thinners are not discontinued, lower doses of them may be prescribed or you may be requested to have regular blood work to make sure they are not decreasing your platelet count. Medications that are known as blood thinners and may decrease your platelet count are warfarin and non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen and naproxen.