DIC mylab NCLEX questions 16-5.1
increased
Fibrin degradation products will be ____________________ as a result of fibrinolysis.
acute
Multiple bruises and an oozing IV site would be noted most often in clients with _____________ DIC.
a
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
elevated
D-dimer will be __________________ in both acute and chronic DIC.
-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: ..................
joint, hypotension
Manifestations of DIC include bleeding, clotting, petechiae, _________ pain., and ________________
ooze blood
Puncture sites such as those from injections or intravenous infusions may __________________ when a client has DIC
elevated
The head of the bed is _________________ to promote diaphragmatic movement and alveolar ventilation.
b, c, d
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
a
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 ____________.
abruptio
______________ placenta is associated with DIC
b
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.
a, b, c, d
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.
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.
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
- 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 : .....................
c
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
d
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
d
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.
b, d, e
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. Using standard pain scale to evaluate and monitor pain and analgesic effectiveness E. Applying cool compresses to painful joints
a, c, e
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
b, c, d
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.
b
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.
c
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
a, b, c, e
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.
b, c, d, e
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
b
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
a, c, d
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
a, b, d, e
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
b
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
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