Cuidados ao portador de púrpura trombocitopênica idiopática - revisão de literatura / Care for patients with idiopathic thrombocytopenic purpura - literature review

Introdução: Conhecida como púrpura trombocitopênica imunonológica, autoimune ou isoimune, a Púrpura Trombocitopênica Idiopática é uma doença hematológica frequente que pode ser aguda, mais frequente em crianças, ou crônica, quando persiste por mais de um ano, típica em adultos. Objetivo: Identificar na literatura científica dados sobre a doença púrpura trombocitopênica, quanto às manifestações clínicas, diagnóstico, tratamento e cuidados de enfermagem. Material e Método: Estudo embasado em revisão integrativa de literatura com busca realizada na base de dados da Biblioteca Virtual da Saúde, Scientific Electronic Library Online e Google Acadêmico, pelos descritores: "Púrpura Trombocitopênica Idiopática", "Cuidados de Enfermagem", e suas respectivas traduções em inglês: "IdiopaticThrombocytopenic Purpura" e "Nursing Care" em associação com operadores booleanos "OR" e "AND", para ampliar a busca dos artigos, dos últimos cinco anos. Resultados: Foram identificados 121 artigos com potencial de relevância, sendo excluídos 4 por duplicidade, totalizando em 117 artigos. Após leitura do título e resumo foram selecionados 17 artigos e excluídos 100. Em seguida, excluídos 12, por não responderem a questão norteadora do estudo, totalizando em 5 artigos para realizar a síntese qualitativa na íntegra. Há destaque quanto a importância da sistematização da assistência de enfermagem para o paciente acometido pela doença, e sobre os desafios da equipe de enfermagem no procedimento de transfusão sanguínea. Também um relato de experiência descreve como é viver com a doença e o tratamento, uma revisão integrativa sobre as manifestações clínicas da doença e a dificuldade de diagnosticar a PúrpuraTrombocitopênica Idiopática. Conclusão: Púrpura Trombocitopênica Idiopática é considerada uma doença grave e de difícil diagnóstico, pois pode ser confundida com outras doenças. O tratamento é específico, realizado com procedimentos de plasmaférese e transfusões sanguíneas em unidades especializadas e de alta complexidade assistencial. Assim, a equipe de enfermagem precisa estar preparada para os cuidados próprios e o enfermeiro, estimulado a desenvolver maneiras de cuidar e pesquisas com abordagens na doença

Introduction: Known as immunological, autoimmune or isoimmune thrombocytopenic purpura, Idiopathic Thrombocytopenic Purpura is a frequent hematological disease that can be acute, more frequent in children, or chronic, when it persists for more than a year, typical in adults. Objective: To identify in the scientific literature data on thrombocytopenic purpura, regarding clinical manifestations, diagnosis, treatment and nursing care. Material and Method: Study based on an integrative literature review with a search carried out in the database of the Virtual Health Library, Scientific Electronic Library Online and Google Scholar, by the descriptors: "Idiopathic Thrombocytopenic Purpura", "Nursing Care", and their respective English translations: "IdiopaticThrombocytopenic Purpura" and "Nursing Care" in association with Boolean operators "OR" and "AND", to expand the search for articles from the last five years. Results: 121 potentially relevant articles were identified, 4 of which were excluded due to duplicity, totaling 117 articles. After reading the title and abstract, 17 articles were selected and 100 were excluded. Then, 12 were excluded for not answering the guiding question of the study, totaling 5 articles to carry out the qualitative synthesis in full. There is emphasis on the importance of systematizing nursing care for the patient affected by the disease, and on the challenges of the nursing team in the blood transfusion procedure. Also an experience report of what it is like to live with the disease and the treatment, an integrative review on the clinical manifestations of the disease and the difficulty of diagnosing Idiopathic Thrombocytopenic Purpura. Conclusion: Idiopathic Thrombocytopenic Purpura is considered a serious disease and difficult to diagnose, as it can be confused with other diseases. The treatment is specific, carried out with plasmapheresis procedures and blood transfusions in specialized and highly complex care units. Thus, the nursing team needs to be prepared for self-care and the nurse encouraged to develop ways of caring and research with approaches to the disease

Introducción: Conocida como púrpura trombocitopénica inmunológica, autoinmune o isoinmune, púrpura trombocitopénica idiopática es una enfermedad hematológica frecuente que puede ser aguda, más frecuente en niños, o crónica, cuando persiste por más de un año, típica en adultos. Objetivo: Identificar datos sobre la púrpura trombocitopénica en la literatura científica, en cuanto a manifestaciones clínicas, diagnóstico, tratamiento y cuidados de enfermería. Material y Método: Estudio basado en una revisión integrativa de la literatura con búsqueda realizada en la base de datos de la Biblioteca Virtual en Salud, Scientific Electronic Library Online y Google Scholar, por los descriptores: "Idiopathic Thrombocytopenic Purpura", "Nursing Care", y sus respectivas traducciones al inglés: "IdiopaticThrombocytopenic Purpura" y "Nursing Care" en asociación con los operadores booleanos "OR" y "AND", para ampliar la búsqueda de artículos de los últimos cinco años. Resultados: Se identificaron 121 artículos potencialmente relevantes, de los cuales 4 fueron excluidos por duplicidad, totalizando 117 artículos. Después de la lectura del título y el resumen, se seleccionaron 17 artículos y se excluyeron 100. Luego, 12 fueron excluidos por no responder a la pregunta guía del estudio, totalizando 5 artículos para realizar la síntesis cualitativa en su totalidad. Se destaca la importancia de sistematizar los cuidados de enfermería al paciente afectado por la enfermedad y los desafíos del equipo de enfermería en el procedimiento de transfusión sanguínea. Además, un relato de experiencia describe cómo es vivir con la enfermedad y el tratamiento, una revisión integradora sobre las manifestaciones clínicas de la enfermedad y la dificultad de diagnosticar la Púrpura Trombocitopénica Idiopática. Conclusión: La púrpura trombocitopénica idiopática es considerada una enfermedad grave, de difícil diagnóstico, ya que puede confundirse con otras enfermedades. El tratamiento es específico, realizado con procedimientos de plasmaféresis y transfusiones de sangre en unidades especializadas de alta complejidad asistencial. Así, el equipo de enfermería necesita estar preparado para el autocuidado y el enfermero incentivado a desarrollar formas de cuidar e investigar con abordajes de la enfermedad

Thrombopoietin Receptor Agonists: Eltrombopag and Romiplostim for the Treatment of Chronic Immune Thrombocytopenia Purpura.

The thrombopoietin receptor agonists, eltrombopag and romiplostim, are second-line agents used to treat chronic immune thrombocytopenia purpura (ITP) in adults and children. ITP is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, petechiae, wet purpura, or blood in the urine or stool. This article reviews ITP treatment for adult and pediatric patients, including the use of the oral agent eltrombopag and the injectible agent romiplostim, nursing considerations, and patient education.

Petechial rash in children: a clinical dilemma.

Children with a petechial rash commonly present to emergency departments. The rash can be associated with serious illnesses, such as invasive meningococcal disease (IMD), but is usually associated with less severe conditions. This article discusses the common and important causes of petechial rash, including IMD, viral illnesses, trauma, Henoch-Schönlein purpura and idiopathic thrombocytopenic purpura. It also analyses the National Institute for Health and Care Excellence (NICE) ( 2014 ) pathway for management of petechial rash in children and examines treatment of the various causes. The article includes two relevant case studies and discusses the role of emergency nurses.

Diagnosis, treatment, and management of immune thrombocytopenia.

Management of immune thrombocytopenia (ITP) requires accurate assessment and evaluation, appropriate treatment strategies, and timely nursing interventions (e.g., monitoring, bleeding prevention, patient education). The overview of ITP in the current article reviews its etiology and provides updates about medical management and key components of nursing care.

Idiopathic thrombocytic purpura.

Oncology nurses often see patients with nononcologic disorders. Idiopathic thrombocytic purpura (ITP), a platelet disorder, is one such example. Being both an emergent condition as well as a chronic one, nurses will need to assess patients with ITP for bleeding and conduct extensive patient education about the disease process and treatment options.

Neonatal petechiae: strategies for nursing interventions.

Planning appropriate nursing care for the neonate with petechiae requires knowledge of its etiology, accurate assessment, and ongoing monitoring. The nurse can use this information to provide interventions that facilitate healing, prevent further sequela, and enhance parental involvement and interaction in the care of their newborn.

Polycythemia, idiopathic thrombocytopenic purpura, and thrombotic thrombocytopenic purpura.

The responsibility of the intravenous nurse is increasing in the multidisciplinary management of patients with idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, and polycythemia. A thorough understanding of these diseases and the treatment modalities is essential for quality patient care. Emphasis is placed on treatment considerations, including blood component administration, therapeutic phlebotomy, and pharmacologic agents.