A school-age child comes to the clinic for evaluation of excessive bruising. The primary care pediatric nurse practitioner notes a history of an upper respiratory infection 2 weeks prior. The physical exam is negative for hepatosplenomegaly and lymphadenopathy. Blood work reveals a platelet count of 60,000/mm3 with normal PT and aPTT. How will the nurse practitioner manage this child's condition?

Question

Quizplus · Accepted Answer

The child's presentation is consistent with immune thrombocytopenia (ITP), which often follows a viral infection and presents with isolated thrombocytopenia (low platelet count) but normal coagulation studies (PT and aPTT). Management for mild cases, as indicated by the absence of significant bleeding and a platelet count above 30,000/mm3, includes observation and advising to avoid activities or medications (like NSAIDs) that could increase bleeding risk. Hospital admission, corticosteroid therapy, or referral to a hematologist might be considered in more severe cases or if the condition does not improve.

A School-Age Child Comes to the Clinic for Evaluation of Excessive