Disseminated Intravascular Coagulation (DIC) - NCLEX questions

Third-degree burns and septic shock

The client with which condition is at the greatest risk of developing acute disseminated intravascular​ coagulation? A. Aortic aneurysm B. Gunshot wound to the distal arm C. Third-degree burns and septic shock D. Bacterial pneumonia treated with antibiotics

elevated

The head of the bed is _________________ to promote diaphragmatic movement and alveolar ventilation.

Heparin therapy

The nurse assesses a client who has bacterial pneumonia and finds​ tachycardia, hypotension,​ oliguria, and acrocyanosis of a foot. Schistocytes are found in a complete blood​ count, and the​ D-dimer is elevated. Which collaborative action should the nurse​ anticipate? A. Warfarin therapy B. Foot amputation C. Dialysis D. Heparin therapy

History of a cancerous tumor

The nurse assesses a client who is diagnosed with chronic disseminated intravascular coagulation​ (DIC). Which finding should the nurse suspect as the probable cause of the​ client's diagnosis? A. History of a cancerous tumor B. Chronic constipation C. History of nosebleeds D. Diminished bowel sounds

Excess release of thrombin uses up clotting factors quicker than they can be replaced.

The nurse concludes that both clotting and bleeding occur during disseminated intravascular coagulation​ (DIC) due to which​ process? A. Tissue damage from bleeding uses up clotting factors quicker than they can be replaced. B. Activation of intrinsic pathways results in release of excess clotting factors. C. Only clotting occurs during​ DIC, as clotting factors are replaced and available to prevent excess bleeding. D. Excess release of thrombin uses up clotting factors quicker than they can be replaced.

Handling extremities gently Standard pain scale to evaluate and monitor pain and analgesic​ effectiveness Applying cool compresses to painful joints

The nurse determined that a client with disseminated intravascular coagulation is experiencing pain. Which intervention should the nurse​ provide? (Select all that​ apply.) A. Encouraging frequent turning and coughing B. Handling extremities gently C. Continuously monitoring oxygen saturation and oxygen administration as ordered D. Standard pain scale to evaluate and monitor pain and analgesic​ effectiveness E. Applying cool compresses to painful joints

Multiple bruises on various skin surfaces Bleeding at the IV insertion site Pale, cool extremities

The nurse is assessing a client suspected of having acute disseminated intravascular coagulation​ (DIC). Which assessment finding supports the​ diagnosis? (Select all that​ apply.) A. Multiple bruises on various skin surfaces B. A history of a malignant tumor C. Bleeding at the IV insertion site D. A history of thyroid disease E. Pale, cool extremities

The client has excessive blood clotting. The client has a history of cancer. Development of DIC has taken months.

The nurse is assessing a client suspected of having chronic disseminated intravascular coagulation​ (DIC). Which finding supports the​ diagnosis? (Select all that​ apply.) A. The​ client's IV infusion site continues to ooze blood. B. The client has excessive blood clotting. C. The client has a history of cancer. D. Development of DIC has taken months. E. The client has multiple bruises on his skin.

Leaked fluid is similar to a coagulation factor.

The nurse is caring for a client diagnosed with placental abruption who now has disseminated intravascular coagulation​ (DIC). Which statement correctly explains why this client is at risk for​ DIC? A. Septic shock due to blood loss. B. Leaked fluid is similar to a coagulation factor. C. Onset of infection. D. Amniotic fluid embolism.

Low-molecular-weight heparin therapy

The nurse is caring for a client who has not responded to platelet and whole blood transfusions as treatment for acute disseminated intravascular coagulation​ (DIC). Which action should the nurse anticipate​ next? A. Coumadin therapy B. End-of-life protocol C. Low-molecular-weight heparin therapy D. Unfractionated heparin therapy

- recent abortion​ (spontaneous or​ therapeutic) - current​ pregnancy - presence of known malignant​ tumor - history of abnormal bleeding​ episodes - a history of hematologic disorders

Risk factors include : .....................

Clotting Bleeding Joint pain Petechiae

A client has disseminated intravascular coagulation​ (DIC). Which clinical manifestation should the nurse expect to​ observe? (Select all that​ apply.) A. Clotting B. Hypertension C. Bleeding D. Joint pain E. Petechiae

"The effects of the disorder will resolve​ completely."

A client with a diagnosis of chronic disseminated intravascular coagulation​ (DIC) is being discharged home. Which statement by the client requires the nurse to follow​ up? A. "I will need to be on a portable infusion pump of​ heparin." B. "The effects of the disorder will resolve​ completely." C. "I understand home healthcare will visit me to monitor the​ infusion." D. "I should call my healthcare provider if I have excessive​ bleeding."

increased

Care of the client with DIC may include mechanical ventilation and control of organ damage from reduced tissue perfusion. Clients with DIC may develop intracranial bleeding resulting in altered levels of​ consciousness, damage to the respiratory​ center, and _________________ intracranial pressure.

elevated

D-dimer will be __________________ in both acute and chronic DIC.

Acute glomerulonephritis Head injury Bacterial infection Acute leukemia

Disseminated intravascular coagulation​ (DIC) is triggered by an injury or agent that activates the clotting cascade. Which condition should the nurse identify as a trigger for the clotting​ cascade? (Select all that​ apply.) A. Acute glomerulonephritis B. Head injury C. Bacterial infection D. Acute leukemia E. Placenta previa

blood​ clotting

Excessive ___________ __________________, as opposed to​ hemorrhage, is usually seen with chronic DIC.

chronic

Excessive blood​ clotting, as opposed to​ hemorrhage, is usually seen with ________________ DIC.

increased

Fibrin degradation products will be ____________________ as a result of fibrinolysis.

-using a standard pain scale to evaluate and monitor pain and analgesic​ effectiveness - handling extremities​ gently - applying cool compresses to painful joints

Interventions for managing pain include: ..................

increase

Laboratory findings that support a diagnosis of DIC include the presence of​ schistocytes, a decreased platelet​ count, and an ____________ in fibrin degradation products or fibrin split products.

joint, hypotension

Manifestations of DIC include​ bleeding, clotting,​ petechiae, _________ pain, and ________________

acute

Multiple bruises and an oozing IV site would be noted most often in clients with _____________ DIC.

tachycardia

Petechiae is a symptom of DIC due to the impaired clotting mechanism leading to bleeding and impaired tissue perfusion. Oliguria or anuria would be​ expected, as would ___________________.

septic

Pregnant clients are at risk for the development of acute DIC from the complications of​ preeclampsia, placental​ abruption, fetal​ demise, amniotic fluid​ embolism, and _____________ abortion

ooze blood

Puncture sites such as those from injections or intravenous infusions may ____________ _______________ when a client has DIC

Elevate the head of the bed. Encourage deep breathing and effective coughing exercises. Administer analgesics and antianxiety​ medications, as ordered. Continuously monitor oxygen saturation.

The nurse is caring for a client who has signs of acute disseminated intravascular coagulation. Which intervention is​ appropriate? (Select all that​ apply.) A. Elevate the head of the bed. B. Encourage deep breathing and effective coughing exercises. C. Administer analgesics and antianxiety​ medications, as ordered. D. Encourage ambulation. E. Continuously monitor oxygen saturation.

Monitoring for organ damage Monitoring need for mechanical ventilation Monitoring intracranial pressure Monitoring for intracranial bleeding

The nurse is caring for a client with disseminated intravascular coagulation​ (DIC). Which collaborative therapy should the nurse include in the​ client's care?​ (Select all that​ apply.) A. Monitoring client allergies B. Monitoring for organ damage C. Monitoring need for mechanical ventilation D. Monitoring intracranial pressure E. Monitoring for intracranial bleeding

Normal fibrinogen levels

The nurse is caring for a client with suspected disseminated intravascular coagulation​ (DIC). Which diagnostic test result supports the diagnosis of​ DIC? A. Decreased fibrin degradation products B. Normal fibrinogen levels C. Increased platelet count D. Decreased​ D-dimer

Decreased platelet count The presence of schistocytes Increased fibrin degradation products

The nurse is evaluating the lab results for a client suspected of having disseminated intravascular coagulation​ (DIC). Which laboratory finding supports the​ diagnosis? (Select all that​ apply.) A. Shortened prothrombin time B. Decreased platelet count C. The presence of schistocytes D. Increased fibrin degradation products E. Elevated hemoglobin

Septic abortion Fetal demise Preeclampsia

The nurse is preparing an educational program about disseminated intravascular coagulation​ (DIC). Which condition should the nurse include as a risk factor for the development of this​ condition? (Select all that​ apply.) A. Septic abortion B. Primigravida C. Fetal demise D. Preeclampsia E. Prolonged labor

Petechiae

The nurse suspects that a patient who has severe sepsis now has disseminated intravascular coagulation​ (DIC). Which​ finding, if​ observed, helps confirm this​ suspicion? A. Petechiae B. Polyuria C. Clear breath sounds D. Bradycardia

DIC

Warfarin is NOT used to treat ____________.

Recent abortion Presence of known malignant tumor Hematological disorder History of abnormal bleeding episodes

Which risk factor should the nurse look for while performing an assessment on a client with a diagnosis of disseminated intravascular coagulation​ (DIC)? ​ (Select all that​ apply.) A. Recent abortion B. Presence of known malignant tumor C. History of diabetes mellitus D. Hematological disorder E. History of abnormal bleeding episodes

Heparin

Which therapy will the healthcare provider prescribe for the client with chronic disseminated intravascular coagulation​ (DIC)? A. Fresh frozen plasma B. Heparin C. Whole blood D. Aspirin regimen

abruptio

______________ placenta is associated with DIC

Pale, cool

________________, ________________ extremities may be noted when a client is bleeding because blood is diverted back to major organs to maintain oxygenation.

Cancer

__________________ is the most common cause of chronic DIC

Leakage

____________________ of fluid similar to a coagulation factor from a placental abruption can trigger DIC.

Decreased

_______________________ platelet count and the presence of schistocytes on the CBC indicate DIC