Acute and chronic immune thrombocytopenic purpura. Disorders that differ in more than duration

Current controversies in the management of idiopathic thrombocytopenic purpura during childhood

Both acute and chronic ITP in children are generally benign conditions. Few patients develop serious complications or long-term sequelae. Therefore, most patients require little or no specific therapy. IVIG or high-dose steroids may benefit some patients who have evidence of clinical bleeding, and splenectomy may be of value in patients with chronic ITP whose lives are altered by low platelet counts or bleeding. It is difficult to predict which patients are at risk for the development of ICH, and severe hemorrhage is not always curtailed by prior or concomitant therapy. The decision to treat a child with ITP should be based on the entire clinical picture rather than on the platelet count alone.

Platelet-associated bleeding disorders

OBJECTIVE

To provide a review of platelet disorders, treatment, and nursing care.

DATA SOURCES

Review articles and book chapters pertaining to quantitative and qualitative platelet disorders.

CONCLUSIONS

Platelet-associated bleeding disorders are classified as quantitative (abnormal number), qualitative (abnormal function), or hypercoagulable states (errors in hemostasis). The resulting complications include thrombocytosis, thrombocytopenia, hypercoagulation, or bleeding dyscrasias. The administration of drugs, plasma, or platelet therapy may be beneficial to these patients.

IMPLICATIONS FOR NURSING PRACTICE

Patients with platelet disorders are at great risk of life-threatening hemorrhage and require close monitoring to prevent unnecessary sequelae. Patient instruction to prevent trauma is required.