Pathophysiology Paper
Thrombocytopenia is a condition in which the blood does not contain enough cell fragments known as platelets. The creation of platelets, along with other blood cells, takes place in the bone marrow, and when the platelets are too few, mild to severe bleeding can occur. This bleeding can take place can be internal bleeding, underneath your skin or on the surface of your skin. Thrombocytopenia can be fatal when severe bleeding takes place in the brain. People with a high risk of this disease include pregnant women, people with genetic conditions, heavy alcohol drinkers, or people diagnosed with certain types of cancer. Early diagnosis and knowledge of thrombocytopenia are crucial for better management and treatment of the disease.
Normal anatomy of the Major body system
The blood is a connective tissue comprising of cellular components such as platelets, red, and white blood cells. The blood cells carry oxygen through the body; the white blood cells fight infection while the platelets stick together around a wound, forming a clot to stop the bleeding (George. 2015). Though made in the bone marrow, certain factors can interfere with bone marrow’s ability to create platelets. Platelets are only about twenty percent in diameter, with the normal platelet count being one hundred and fifty thousand to three hundred thousand per microliter or blood (George. 2015). This ratio means that the platelets are microscopic, making a very minimal fraction of the blood volume. The platelets are, therefore, not actual cells but merely cell fragments shaped like plates hence the name platelets. Platelets are, consequently, very vital elements of the blood.
Normal Physiology of the Major Body System
While the platelets are merely cell fragments, they contain structures vital to ensuring bleeding stops. They contain proteins on the surface, allowing them to stick to cuts or breaks in the walls of the blood vessels and also to stick together, forming a clot (George. 2015). Platelets also contain granules that secrete other forms of proteins required to create a plug or clot to sell the breaks or cuts in the blood vessels (George. 2015). Additionally, platelets have muscle proteins that allow them to change their shape when their texture becomes sticky. When an injury releases the platelet, they change their form becoming round, and they extend the filaments having an octopus-like appearance reaching out to make contact with the damaged blood vessel and the other platelets (George. 2015). Through this change of shape, they can seal the broken blood vessel.
Mechanism of Pathophysiology
The disease occurs when there are less than one hundred and fifty thousand platelets in the body per microliter. Typically, platelets have a lifespan of ten days, and the body is supposed to renew the supply in the bone marrow (National Heart, Lung, and Blood Institute, 2020). Thrombocytopenia occurs when platelet circulating reduces due to various reasons such as some platelets trapped in the spleen. Thrombocytopenia also occurs when the bone marrow fails to produce a reasonable or adequate number of platelets (Izak & Bussel, 2014). Still, patients with certain illnesses can face situations when platelets are destroyed by the diseases, for instance, leukemia, certain types of anemia, viral infections such as HIV or hepatitis C (National Heart, Lung, and Blood Institute, 2020). Thrombocytopenia is rarely hereditary, and often circumstances such as these cause the disease to take place. When there are few platelets, a break in a blood vessel, complete sealing does not occur, causing excessive bleeding.
Prevention
Prevention of thrombocytopenia is not possible, but it is possible to lessen the effects of the disease. This prevention may occur through limiting alcohol intake because alcohol slows down the production of platelets in the body (Cleaveland Clinic, 2017). It is advisable to discuss the side effects of medication with the doctor to avoid drugs that may slowly decrease the platelet count in the body. Still, blood thinner medicine, such as Naprosyn and ibuprofen, could cause the disease requiring nonusage of these NSAIDs (Cleaveland Clinic, 2017). It is also advisable to avoid activities that are likely to cause injuries or bruises.
Treatment
Treatment for thrombocytopenia can vary depending on the situation. For instance, if complications with a patient’s immune system cause the disease, the physician can prescribe steroids, immunoglobulin, or other medication (Cleaveland Clinic, 2017). For severe thrombocytopenia, platelet transfusions are usually the leading solution. Still, in different situations, removing the spleen may be appropriate to prevent it from destroying the platelets. However, this can expose the patient to risks of infections (Cleaveland Clinic, 2017). Nurse intervention is critical for such patients as they ensure patients are educated on NSAIDs necessary precautions to avoid bleeding. Nurses also can observe the skin for any petechial wounds where bleeding may occur. With critical knowledge, the disease is manageable.
Conclusion
Thrombocytopenia is a disease that requires medical care and added precautions to prevent any complications. Platelets are a vital part of the blood, and excessive bleeding is possible when they are low in numbers. Prevention of the disease is not possible, but it is possible to prevent injuries and occurrences that can trigger it. Primary treatment can range from platelet transfusion to the removal of the spleen; however, this would depend on the severity of the disease. While the condition may be severe, patients should know that it is possible to live a full life while adhering to necessary precautions.
References
Cleaveland Clinic. (2017). Thrombocytopenia Management and Treatment | Cleveland Clinic. Retrieved 26 May 2020, from https://my.clevelandclinic.org/health/diseases/14430-thrombocytopenia/management-and-treatment
George. N. J. (2015). Platelets on the Web. Hematology-Oncology Section, Department of Medicine-University of Oklahoma Health Sciences Center. Retrieved 26 May 2020, from https://ouhsc.edu/platelets/index.html
Izak, M., & Bussel, J. B. (2014). Management of thrombocytopenia. F1000prime reports, 6, 45. https://doi.org/10.12703/P6-45
National Heart, Lung, and Blood Institute (NHLBI). (2020). Thrombocytopenia | Retrieved 26 May 2020, from https://www.nhlbi.nih.gov/health-topics/thrombocytopenia