Chapter 30: Disseminated Intravascular Coagulation and other problems of hemostasis
The nurse would select which IV solution to prime blood tubing prior to the administration of a unit of packed red blood cells (RBCs)?
0.9% sodium chloride, also known as normal saline.
Which diagnostic finding would the nurse expect to find in a patient with acute disseminated intravascular coagulation (DIC) who experiences bleeding?
Elevated D-dimers
which condition is life-threatening and assumed to be a type of severe preeclampsia?
HELLP syndrome
Which therapy for disseminated intravascular coagulation (DIC) disorder may be prescribed for a patient when the benefits outweigh the risk?
Heparin
Which factors put a patient at risk for developing acute disseminated intravascular coagulation (DIC)?
Septicemia An extensive burn Abruptio placentae Severe head trauma
Which effect does desmopressin acetate have on clotting factors?
it stimulates an increase in factor VIII
which instructions would the nurse include when educating a patient with chemotherapy induced thrombocytopenia?
walk with sturdy shoes avoid blowing the nose forcefully shave only with an electric shaver
Which condition places a patient at risk for developing chronic or subacute disseminated intravascular coagulation (DIC) disorder?
malignant disorder chronic and subacute DIC disorder is most commonly seen in patients with long-standing illnesses such as malignant disorders.
which assessment would the nurse perform to determine the presence of external bleeding?
petechiae
which length of time would the nurse stay at the bedside of a patient when initiating a unit of packed red blood cells?
15 minutes patients who are likely to have a transfusion reaction most often will exhibit signs within the first 15 minutes that the blood is infusing.
Which pulmonary manifestation is a result of deposition of platelets in the microvasculature?
Acute respiratory distress syndrome (ARDS) thrombotic manifestations occur as a result of fibrin or platelet deposition of the microvasculature. The pulmonary manifestation associated with thrombosis in the microvasculature ARDS
The nurse recognizes that fibrin split products (FSPs) interfere with blood coagulation mechanisms by performing what functions?
Coating the platelets attaching to fibrinogen interfering with thrombin
Bleeding manifestations in a patient with disseminated intravascular coagulation (DIC) may be caused by which pathophysiologic factors?
Consumption of platelets depletion of coagulation factors formation of fibrin split products (FSPs)
Which blood product is prepared from fresh frozen plasma?
Cryoprecipitate a blood product prepared from fress frozen plasma and available in 10 to 20mL/bag.
Which information would the nurse include when preparing to discuss the etiology and pathophysiology of disseminated intravascular coagulation (DIC)?
DIC is a secondary disease of clotting and hemorrhage. DIC disorder is a disorder in which underlying disease stimulates the coagulation system leading to diffuse clotting and hemorrhage. it is a disorder in which the underlying disease depletes clotting factors in blood.
Which factor rises with inflammation and may produce a false-positive result when used to diagnose disseminated intravascular coagulation (DIC)?
Factor V
Cryoprecipitate therapy is helpful in the treatment of disseminated intravascular coagulation (DIC) disorder because it replaces which factor?
Factor VIII which plays a major role in clotting.
The blood bank notifies the nurse that the two units of blood ordered for a patient is ready for pick up. Which action should the nurse take to prevent an adverse effect during this procedure?
Infuse the blood slowly for the first 15 minutes of the transfusion
which assessment finding may indicate the development of disseminated intravascular coagulation (DIC) in a patient who experienced an anaphylactic response?
blood oozing from venipuncture sites
A patient with a platelet count of 52,000 is diagnosed with thrombocytopenia. The nurse would expect which clinical manifestations?
brusining and petechiae
which manifestation would the nurse monitor for in a patient with chronic disseminated intravascular coagulation (DIC) disorder?
cyanosis of the extremities ineffective peripheral tissue perfusion and acute pain are the nursing diagnoses related to a patient with chronic DIC disorder. The priority nursing intervention while caring for the patient is to examine for cyanosis of the extremities.
Which laboratory result may be found in patients with disseminated intravascular coagulation (DIC) disorder>
decreased protein C and S due to depletion of clotting factors
which intervetions would the nurse include in the discharge teaching for a patient with neutropenia?
encourage the patient to wash hands frequently advise the patient to notify the health care provider if a fever develops advise the patient to brush the teeth four times a day with a soft toothbrush
The nurse assesses a patient and identifies signs of hemorrhage based on which changes in the mucous membranes?
epistaxis
which finding would the nurse expect when assessing a patient with acute myelogeous leukemia (AML)?
hypercellular bone marrow with myeloblasts
Which sign of microvascular thrombosis observed in a patient with disseminated intravascular coagulation (DIC) disorder is associated with the integumentray system?
ischemic tissue necrosis
Which laboratory test can confirm the presence of fragmented erythrocytes in a patient suspected of having acute disseminated intravascular coagulation (DIC)?
peripheral blood smear fragmented erythrocytes or schisocytes are indicative of partial occlusion of small vessels by fibrin thrombi. Peripheral blood smear test detects the presence of fragmented erythrocytes.
which patient's diagnostic findings are consistent with chronic myelogenous leukemia (CML)?
presence of philadelphia chromosome
which laboratory results would the nurse expect to find when assessing a patient with myelodysplastic syndrome (MDS)>
a deficiency of granulocytes inefficiently functioning platelets MDS commonly manifests as infection and bleeding caused by inadequate numbers of ineffective functioning circulating granulocytes or platelets
Which event that occurs during disseminated intravascular coagulation (DIC) may predispose a patient to hemorrhage?
accumulation of fibrin split products (FSPs)
which nursing intervention would be appropriate in the care of a patient diagnosed with immune thrombocytopenic purpura (ITP)?
administration of oral or IV corticosteroids used to suppress the phagocytic response of splenic macrophages.
Which laboratory levels may be decreased in acute dissemiated intravascular coagulation (DIC)?
antithrombin III (AT III) levels fibrinogen and platelet levels Protein C and protein S levels
which interventions would the nurse provide a patient who has polycythemia?
evaluating fluid intake and output assessing the patient's nutritional status initating active and passive leg exercises
Which parameters would the nurse assess while monitoring a patient for the development of disseminated intravascular coagulation (DIC) disorder?
fibrinogen levels partial thromboplastin time (PTT)
Which condition may contribute to the development of disseminated intravascular coagulation (DIC)?
imbalance in the coagulation system
The nurse caring for a patient with polycythemia vera would expect which assessment finding?
increased hemoglobin in polycythemia vera, hemoglobin and hematocrit are increased because of a hyperproliferation of red blood cells.
Which body system would the nurse assess to determine the signs of external bleeding in a patient with disseminated intravascular coagulation (DIC) disorder?
integumentary
Which information would the nurse include when teaching nursing students about treatment for disseminated intravascular coagulation (DIC)?
oxygentation helps to stabilize the patient with DIC as a part of collaborative care, it is necessary to diagnose DIC disorder quickly through oxygenation or volume replacement to control the thrombosis and bleeding.
