Question:
Discuss about thrombocytopenia and its associated consequence, pathophysiology associated with thrombocytopenia, clinical manifestation and complications and Correlation of influences with level of wellness?
Answer:
Introduction
Understanding the pathophysiological process for any concerned health problem is crucial because it helps in identifying exact measure for the restoration of the disorder. With the complete understanding of causes, associated changes in the physiological system and mode of transmission, it is easy to trace the measures for control (Kassam-Adams, 2014). The simpler means of identification of any disease problem is the detection of its sign and symptoms. It is hence accurate assessment, and intervention is the next approach for health restoration. On the contrary, the information collected from any particular problem can be made accountable for the future scope, which also acts as reference. The same evidence is useful as prophylaxis or evidence-based practice.
The present paper is based on detailed analysis, and risk assessment of one such problem referred as thrombocytopenia (Huether & McCance, 2013). The disorder is linked to relative decrease in the thrombocyte, which is blood platelet. In general the count for blood platelet in the physiological system is a range within 15,000 to 4,50,000 per microliter of blood. Determination of limit for thrombocytes accounts on the basis of upper percentile over the blood calculation and hence the count outside of limit is not an indicative of the diseased condition. On the contrary, there is an emergency care necessary if the platelet count is below 50,000 per microliter of blood. An account of reduced blood platelet in an individual is attributed to numerous factors including nose bleeding, bleeding gums, heavy bleeding during the menstrual cycle of women and spontaneous bleeding under the skins. The adjunct diagnosis of the physiological system, to confirm for any particular disorder, have basis over complete analysis of count for other important blood elements (Huether & McCance, 2013). Thus, the number for other blood cell types including red blood cells and white blood cells is crucial in accordance with the condition of thrombocytopenia.
Thrombocytopenia and its associated consequence
Individuals are suffering from thrombocytopenia usually have complications relate to fatigue, weakness in muscles and malaise. Intervention for this disease requires an intensive inspection of the bleeding evidence and its possible cause. The driving force of bleeding in the body system often is linked with disorder or failure of any organ system, or may be linked with side effects of any medication. Trauma and faintness are the immediate sign associated with the problem; that helps in early detection (Huether & McCance, 2013). In case the blood platelet count is within a range of 15,000 to 30,000 per mm3 blood volume, there appears spontaneous bruising in the patient. It is noteworthy to mention that the problem of thrombocytopenia has evidences to appear in adolescent and elderly patients. Apart from this, there are certain neonatal cases where the prevalence of the disease is also high. The possible cause associated with the neonatal complication relates to autoimmune, genetic, and alloimmune reason (Peterson, McFarland, Curtis & Aster, 2013). Often in other cases where massive bleeding links with the condition, there is an emergency need for medical service for health restoration.
Pathophysiology associated with thrombocytopenia
The cause associated with the complication of thrombocytopenia links with inherited, acquired or medication-induced reasons. It is hence for a confirmatory diagnosis; it is essential completely to identify the associated cause that helps in finding appropriate measure for restoration. Condition like leukemia, aplastic anemia, dehydration, folic acid deficiency, bone marrow megakaryocytes and immunological shortening of platelet survival are a common cause for thrombocytopenia (Huether & McCance, 2013). The hereditary syndrome is also one of the key reasons of such problem such as congenital amegakaryocytic, Fanconi’s anemia, gray platelet syndrome, and whisk ott-Aldrich syndrome. Other this, decreased production of thrombopoietin in the liver, viral or bacterial infection, systemic sepsis, and dengue fever are also known to be responsible for such condition.
In some of the clinical condition, there is an increased reduction of the blood platelet that leads to a shortage of count in blood volume. Examples of such clinical conditions include idiopathic thrombocytopenia and thrombotic thrombocytopenic purpura, hemolytic uremic syndrome and Systemic lupus erythematosus. Conditions such as post-transfusion purpura, Gaucher’s disease, and HIV-associated thrombocytopenia are also includes within the scope. As mentioned in the above section alloimmune or error in genetic makeup is also responsible for the condition of thrombocytopenia in neonatal cases (Peterson, McFarland, Curtis & Aster, 2013). Importantly, there is also evidence present, which indicates the state of thrombocytopenia as a side effect for any particular medication use. Drugs such as valproic acid, methotrexate, isotretinoin, proton pump inhibitors and methotrexate are responsible for causing destruction of blood platelet as side effects of their usage.
Clinical manifestation and complications
Laboratory diagnosis of the condition includes the analysis with respect to full blood count, liver enzymes, renal function, a peripheral smear of blood, and erythrocyte sedimentation rate. In case, the identification of cause analysis is not clear, it is necessary to undertake the bone marrow biopsy (Rodeghiero, 2013). Apart from platelet counting, screening for clotting function is also necessary. Notably, in certain cases there are evidences that the ineffective production of the platelet in the physiological condition is also responsible for thrombocytopenia like condition. Similar concerns are important to take care, as because they are indicative of malignant disease process.
Correlation of influences with level of wellness
Treatment of thrombocytopenia is based on the general etiology and severity of disease conditions. The mainframe of treatment is to identify the cause associated with thrombocytopenia and subsequently eliminate the cause. Hematologist generally guides the treatment of such problem. Often there is a necessity for blood product usage, which should be practices with the optimum monitoring process (Rodeghiero, 2013). Patient education and taking consent from the patient regarding the intervention and care plan is necessary for routine practice for care. Similarly, the use of medication for the management that includes corticosteroids, folic acid supplement, and lithium carbonate substituent should be used with proper evidence-based practice.
Conclusion
In conclusion, the present paper focus on the hematological problem related to thrombocytopenia. The associated complication, the probable cause of the problem and its corresponding health outcomes are discussed in complete detail. Notably, the problem of thrombocytopenia is links with hereditary, autoimmune and adverse physiological condition, but in certain case side effects of medication are also responsible. As for treatment measure, it is important to identify the cause of the problem and elimination from the physiological system. Hence medication management in this regard is crucial. Furthermore, it is also essential to take consent from the patient in conjunction with the treatment approach and intervention techniques.
References
Huether, S. E., & McCance, K. L. (2013). Understanding pathophysiology. Elsevier Health Sciences. 510-515.
Kassam-Adams, N. (2014). Design, delivery, and evaluation of early interventions for children exposed to acute trauma. European journal of psychotraumatology, 5.
Peterson, J. A., McFarland, J. G., Curtis, B. R., & Aster, R. H. (2013). Neonatal alloimmune thrombocytopenia: pathogenesis, diagnosis and management. British journal of haematology, 161(1), 3-14.
Rodeghiero, F., Michel, M., Gernsheimer, T., Ruggeri, M., Blanchette, V., Bussel, J. B., … & Stasi, R. (2013). Standardization of bleeding assessment in immune thrombocytopenia: report from the International Working Group. Blood, 121(14), 2596-2606.
