Platelet Defects PDF

10/19/23, 3:17 AM Realizeit for Student Platelet Defects Quantitative platelet defects (i.e., thrombocytopenia, thrombocytosis) are not uncommon, however qualitative defects may also occur. Despite normal platelet counts, when qualitative defects are present, platelets do not function normally. A...

10/19/23, 3:17 AM Realizeit for Student Platelet Defects Quantitative platelet defects (i.e., thrombocytopenia, thrombocytosis) are not uncommon, however qualitative defects may also occur. Despite normal platelet counts, when qualitative defects are present, platelets do not function normally. A platelet function analyzer is used to evaluate platelet function. This technique is valuable for rapid screening. Examination of platelet morphology with the peripheral blood smear in the laboratory can also identify possible qualitative defects. Platelet morphology is frequently hypogranular and pale and may also be larger than normal (Coutre, 2018). Aspirin may induce a platelet disorder. Even small amounts of aspirin can reduce normal platelet aggregation and increase bleeding time for several days after ingestion. Although this typically does not cause bleeding in most people, patients with thrombocytopenia and coagulation disorders such as hemophilia can experience significant bleeding after ingestion of aspirin, especially in conjunction with trauma and invasive procedures. NSAIDs can also impair platelet function, but the effects are not as prolonged as with aspirin (4 days vs. 7 to 10 days). Other causes of platelet dysfunction include end-stage renal disease, MDS, multiple myeloma, cardiopulmonary bypass, herbal remedies, and other medications. Clinical Manifestations Bleeding can range from mild to severe. The severity does not necessarily correlate with the platelet count or with tests that measure coagulation (prothrombin time [PT], activated partial thromboplastin time [aPTT]). However, results from these tests may be useful in determining the etiology of the bleeding disorder when abnormalities are present (Levi, Seligsohn, & Kaushansky, 2016). For example, an elevated PT in the setting of a normal aPTT and platelet count may suggest factor VII deficiency, whereas an elevated aPTT in the setting of a normal PT and platelet count is suggestive of von Willebrand disease (vWD) or hemophilia. Ecchymoses, particularly on the extremities, are frequently evident. Patients with platelet dysfunction are at increased risk for bleeding after trauma or invasive procedures (e.g., dental extraction, biopsy). Medical Management Platelet dysfunction that is associated with a medication requires stopping the medication when possible, especially when bleeding occurs. If platelet dysfunction is present, bleeding may be prevented by transfusion of platelets prior to an invasive procedure. Antifibrinolytic agents (e.g., aminocaproic acid) may be needed to prevent significant bleeding after procedures; desmopressin, a synthetic vasopressin analogue, can reduce the duration of bleeding and improve hemostasis for some patients (Levi et al., 2016). https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IagsrRDoag8O5uY%2buyG45kbB3bvIg9mMgs36U0K0gCcv… 1/2 10/19/23, 3:17 AM Realizeit for Student Nursing Management Patients with platelet dysfunction should be instructed to avoid substances that can interfere with platelet function. These include OTC medications such as aspirin and NSAIDs, as well as some herbal preparations, nutritional supplements, and alcohol. Patients should notify all health care providers, including dentists, of their underlying condition before undergoing any invasive procedure so that measures to reduce risk for bleeding can be implemented. Maintaining good oral hygiene is important to promote good dental health and reduce risk for gingival bleeding. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=0Dn26kXyU%2f6F5gOCz4%2f2IagsrRDoag8O5uY%2buyG45kbB3bvIg9mMgs36U0K0gCcv… 2/2