Kankana Kar: Low Platelets Doesn’t Mean Bleeding, Sometimes it Means Clots
Kankana Kar, Associate Professor at GitaRam Institute of Nursing, shared a post on LinkedIn:
“Issue No 06
Low platelets doesn’t mean bleeding. Sometimes it means Clots.
A post-op patient on Heparin develops a sudden platelet drop from 300,000 to 120,000/mm³.
Most clinicians think:
Bleeding Risk
But the real danger is often far worse:
Heparin-Induced Thrombocytopenia (HIT) Type II
In HIT, platelets are not disappearing – they are being consumed to form dangerous clots that can cause:
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism (PE)
- Stroke
- Acute Limb Ischemia
- Amputation
NCLEX Pearl: A platelet count can still be ‘normal’ and yet indicate HIT if it has fallen by ≥50% from baseline.
- Stop ALL forms of Heparin immediately
- Monitor for signs of thrombosis, not just bleeding
- Anticipate alternative anticoagulation (e.g., Argatroban)
- No LMWH (Enoxaparin)
- No routine platelet transfusions
- No early Warfarin
Remember:
HIT is the same as Clotting Crisis with a Low Platelet Count
Save this post for your NCLEX review and share it with a fellow nurse preparing for boards or critical care practice.”

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