Petechiae

Definition

Petechiae are small (less than 2 mm), flat, round, red or purple spots caused by bleeding from capillaries. They do NOT blanch with pressure (distinguishing from erythema).

Causes

• Thrombocytopenia (platelets less than 50,000/µL)
• Platelet dysfunction
• Infections: meningococcemia, Rocky Mountain spotted fever, endocarditis
• Vasculitis
• ITP (immune thrombocytopenic purpura)
• Severe hypertension
• Child abuse (especially on soft tissue areas)

Nursing Interventions

Assess platelet count and coagulation labs. Petechiae + fever + altered mental status in young adult = suspect meningococcemia (droplet precautions, empiric antibiotics immediately). Bleeding precautions: soft toothbrush, electric razor, no IM injections. Monitor for other bleeding.

NCLEX Relevance

Non-blanching pinpoint hemorrhages = low platelets or serious infection.