Platelets (PLT) Lab Values

Overview

1. Platelets
   1. Normal Value Range
   2. Pathophysiology
   3. Special considerations
   4. Elevated platelet levels
   5. Decreased platelet levels

Nursing Points General

1. Normal value ranges
   1. 100,000 – 450,000/mcL
   2. Also known as – Thrombocytes
2. Pathophysiology
   1. Formed from Megakaryocyte
      1. Formed from bone marrow
      2. Produces 1000-3000 platelets
   2. Injury occurs at site
      1. Collagen releases activators
      2. Thrombocytes activate "sticky fingers", which allow them to bind together.
      3. Travel to site (along with other clotting factors)
      4. Adhere to site, increase stimulation for other PLT, until clot is formed with fibrin
3. Special considerations
   1. Use a lavender top tube (EDTA)
   2. Often sent in CBC
4. Abnormal lab values
   1. Elevated platelets (thrombocytosis)
      1. Cancers
      2. Absence of a spleen
         1. Breaks down platelets
      3. Birth control
      4. Polycythemia vera
         1. Overproduction of cells
         2. Treatment via bloodletting, medications or hydration
   2. Decreased platelets (thrombocytopenia)
      1. ITP (Idiopathic thrombocytopenic purpura)
         1. Autoimmune disease
         2. Medications
      2. Hemorrhage
         1. Treated with transfusion
      3. Leukemia
         1. Treated with chemotherapy/radiation
      4. Medications
         1. Some diuretics
         2. Nonsteroidal anti-inflammatory drugs (NSAIDs)
         3. Ranitidine
         4. Some antibiotics

Assessment

1. Assess for signs of petechia (small purplish blemishes, indicating bleeding)

Therapeutic Management

1. Control and stop hemorrhage
   1. Replace platelets via transfusion
2. Consider stopping or changing medications that cause thrombocytopenia

Nursing Concepts

1. Lab Values
2. Clotting

Patient Education

1. For patients who have bleeding disorders, instruct patients to be cautious of injury.
2. If patient has thrombocytopenia, instruct patient to seek emergency treatment in the event of bleeding that does not stop.

**DISCLAIMER – The video states that the normal value of platelets is 100,000 – 400,000 cells/mcL. The correct information is 100,000 – 450,000 cells/mcL.