Thrombocytopenia: NCLEX Priorities
ITP, HIT, TTP: causes, bleeding risk, platelet transfusion thresholds.
Low platelets have many causes. NCLEX tests bleeding risk, HIT recognition, and platelet thresholds.
Definitions
<150K is low. Bleeding risk real <50K, severe <20K, spontaneous <10K.
ITP (immune)
Autoimmune. Steroids first, IVIG, splenectomy, TPO agonists.
HIT
Heparin-induced. >50% drop from baseline, 5-14 days after starting heparin. Paradoxical thrombosis. Stop all heparin, switch to argatroban or bivalirudin.
TTP
Pentad: fever, thrombocytopenia, MAHA, AKI, neuro. Plasma exchange lifesaving.
Platelet transfusion
Generally <10K spontaneous bleed prophylaxis. <50K for procedures or active bleeding. Higher for neurosurgery.
Frequently asked
Fall precautions with low platelets?
Yes <50K typically. Bleed risk significant.
Heparin flushes count for HIT risk?
Yes, any heparin exposure. Use saline flushes in HIT history.
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