Why does unexplained multiple bruising in a child or adult require prompt medical attention? How might you understand the natural concern by medical personnel as to the source of the bruises on Billy’s body?
A call to the doctor’s office from an anxious mom reports that her 8-year-old son, Billy, arrives home from school with multiple small bruises (petechiae) and a few larger bruises (ecchymosis) on his arms, legs, and trunk. These bruises were not there when he left for school, and Billy denies being hit or falling. Mom states that he has no significant medical history, and that he is not on any medications. Billy is taken immediately to the emergency room. The mother becomes increasingly anxious as she notices new bruises appearing “in front of her eyes.” Billy also appears tense as he senses some urgency and notices some concern from medical personnel beginning the assessment.
- Why does unexplained multiple bruising in a child or adult require prompt medical attention?
- How might you understand the natural concern by medical personnel as to the source of the bruises on Billy’s body?
Early assessment of Billy’s vital signs and the child’s welfare indicate that Billy’s condition is stable, and the history, physical examination, and laboratory testing ensue. Most notably, results of the complete blood count (CBC) and peripheral blood smear point to the diagnosis of ITP.
- How do the above abnormal test results relate to Billy’s event of spontaneous bruising?
The treatment includes intravenous administration of immune globulin to increase the platelet count, corticosteroids to increase capillary stability, and vitamin K therapy to improve clotting mechanisms. Billy responds quickly to therapy. You have been designated to go over the physician’s written instructions for patient/parent teaching.
- What issues might be addressed with the parent?
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