A patient with idiopathic thrombocytopenia purpura continues to experience symptoms of the disease after completing several courses of prednisone therapy. The nurse anticipates that which treatment will most likely be recommended for this patient?
1. lifelong prednisone therapy
2. splenectomy
3. aspirin therapy
4. weekly platelet transfusions
Correct Answer: 2
A splenectomy is the treatment of choice if the patient with idiopathic thrombocytopenia purpura relapses when glucocorticoids are discontinued. The spleen is the site of platelet destruction and antibody production. This surgery often cures the disorder, although relapse may occur years after splenectomy. Aspirin therapy would likely result in bleeding and would be contraindicated in this situation. Platelet transfusions are ineffective with this disorder because the problem is that platelets are being produced adequately but are destroyed. Lifelong prednisone therapy is rarely prescribed and prednisone therapy has already proven ineffective for this patient.
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