Disseminated Intravascular Coagulation (DIC)
A nurse is reviewing the laboratory results of a patient suspected to have disseminated intravascular coagulation (DIC). Which of the following laboratory findings would be most indicative of DIC?
A) Increased platelet count and prolonged prothrombin time (PT)
B) Decreased fibrinogen levels and elevated D-dimer levels
C) Normal activated partial thromboplastin time (aPTT) and normal fibrinogen levels
D) Increased platelet count and normal D-dimer levels
B) Decreased fibrinogen levels and elevated D-dimer levels
In DIC, there is a consumption of clotting factors, leading to decreased fibrinogen levels and elevated D-dimer levels, indicating the presence of fibrin degradation products due to increased clotting activity.
A nurse is caring for a patient with suspected deep vein thrombosis (DVT). Which of the following diagnostic tests is most commonly used to confirm the presence of a DVT, and what lab result would support the suspicion of a clot?
A) D-Dimer: elevated levels suggest presence of blood clot; Ultrasound is used for confirmation.
B) Chest X-ray: reveals pleural effusion; D-Dimer: low levels indicate no clot.
C) MRI: detects muscle tears; Ultrasound: assesses muscle injuries.
D) CT scan: evaluates lung function; D-Dimer: elevated levels indicate pulmonary embolism.
A) D-Dimer: elevated levels suggest presence of blood clot; Ultrasound is used for confirmation.
D-Dimer: elevated levels suggest presence of blood clot
Ultrasound
A nurse is reviewing the diagnostic tests ordered for a patient suspected of having a pulmonary embolism (PE). Which of the following tests would provide the most definitive confirmation of a PE?
A) D-Dimer
B) Computed Tomography (CT) pulmonary angiography
C) Magnetic Resonance Angiography (MRA)
D) Chest X-ray
B) Computed Tomography (CT) pulmonary angiography
CT pulmonary angiography is considered the gold standard for diagnosing pulmonary embolism because it provides direct visualization of the blood vessels in the lungs and can clearly show the presence of a clot
D-Dimer, CT, Magnetic Resonance Angiography (MRA)
A nurse is reviewing the laboratory results of a patient diagnosed with anemia. Which of the following findings would most likely be observed in a patient with anemia, regardless of the specific type?
A) Hemoglobin (Hgb) level above 13 g/dL and hematocrit (Hct) above 40%
B) Hemoglobin (Hgb) level of 10 g/dL and hematocrit (Hct) of 30%
C) Hemoglobin (Hgb) level of 14 g/dL and hematocrit (Hct) of 42%
D) Hemoglobin (Hgb) level of 15 g/dL and hematocrit (Hct) of 48%
B) Hemoglobin (Hgb) level of 10 g/dL and hematocrit (Hct) of 30%
A 40 year old develops disseminated intravascular coagulation (DIC). Upon obtaining the history, which finding is the most likely cause of this condition?
A. Snakebite
B. Blood transfusion
C. Sepsis
D. Immune thrombocytopenic purpura (ITP)
C. Sepsis
Severe infections-Sepsis, Cancer, severe trauma, Extensive surgery, Severe burns
A nurse is educating a group of students about the risk factors for deep vein thrombosis (DVT). Which of the following combinations of risk factors would most significantly increase a patient’s risk for developing DVT?
A) Prolonged immobility, recent surgery to the legs or hips, and pregnancy
B) Regular exercise, high-fiber diet, and hydration
C) Use of oral contraceptives, family history of DVT, and age over 60
D) Smoking cessation, weight loss, and increased physical activity
A) Prolonged immobility, recent surgery to the legs or hips, and pregnancy
Prolonged Immobility, surgery to legs or hips, Pregnancy, Oral contraceptives
A patient presents with severe chest pain and shortness of breath and is diagnosed with pulmonary embolism. The embolism most likely originated from the:
A. left ventricle.
B. systemic arteries.
C. deep veins of the leg.
D. superficial veins of the arm.
C. deep veins of the leg.
Immobility, Heart failure, trauma, infection, oral contraceptives, pregnancy, surgery, clotting disorders, recent DVT
A nurse is educating a patient about the risk factors for developing anemia. Which of the following risk factors is most directly associated with the development of anemia in general?
A) Chronic blood loss due to heavy menstruation
B) Increased consumption of fortified foods
C) Regular aerobic exercise
D) High intake of dietary fiber
A) Chronic blood loss due to heavy menstruation
Dependent on anemia: Dietary deficiency, malabsorption, blood loss, increased demand
A nurse is caring for a patient diagnosed with disseminated intravascular coagulation (DIC). Which of the following nursing considerations is most critical to implement for this patient?
A) Administering anticoagulants to prevent further clot formation
B) Monitoring for signs of bleeding and organ dysfunction, and implementing appropriate interventions
C) Encouraging the patient to ambulate frequently to promote circulation
D) Initiating fluid restriction to prevent fluid overload
B) Monitoring for signs of bleeding and organ dysfunction, and implementing appropriate interventions
In a patient with DIC, it is critical to monitor for signs of bleeding (such as petechiae, ecchymosis, or hematuria) and signs of organ dysfunction (such as changes in mental status or urine output) due to the complex nature of the disease, which involves both clotting and bleeding.
Monitor for signs of bleeding, Vital signs, organ dysfunction
A 60 year old undergoes surgery for a bone fracture. Which nursing measure would be most effective for preventing pulmonary embolism (PE) in this patient?
A. Ensure that patient uses supplemental oxygen.
B. Prevent deep vein thrombosis formation.
C. Check hematocrit and hemoglobin levels frequently during the postoperative period.
D. Promote aggressive fluid intake.
B. Prevent deep vein thrombosis formation.
Monitor for S/S, DVT Prevention, SCDs, and Prophylactic Anti-coagulation
Which of the following patients is at highest risk for developing pulmonary embolism (PE)?
A. A 21-year-old male with a hemophilia bleeding disorder
B. A 28-year-old woman who had a baby 6 months earlier
C. A 36-year-old woman with a history of alcohol abuse who is recovering from a gastric ulcer
D. A 72-year-old male who is recovering from hip replacement surgery in the hospital
D. A 72-year-old male who is recovering from hip replacement surgery in the hospital
Monitor VS, O2 as needed, anti-coagulants, monitor for signs of bleeding, DVT education, Increase HOB, monitor patient
A nurse is developing a care plan for a patient diagnosed with anemia. Which of the following nursing considerations should be prioritized to effectively manage the patient's condition?
A) Encourage the patient to increase fluid intake to 3 liters per day.
B) Focus on the treatment of underlying conditions and address associated symptoms through dietary corrections and supplementation.
C) Advise the patient to avoid all physical activity until hemoglobin levels are normalized.
D) Limit patient education to information about dietary restrictions only.
B) Focus on the treatment of underlying conditions and address associated symptoms through dietary corrections and supplementation.
Treatment of underlying condition according to different types of anemias and decrease of associated symptoms.
Ex: Dietary correction, transfusion, administration of vitamins or iron.
A nurse is assessing a patient with suspected disseminated intravascular coagulation (DIC). Which of the following combinations of signs and symptoms would most strongly suggest the presence of DIC?
A) Severe headache, visual disturbances, and hypertension
B) Unilateral leg swelling, warmth, and calf pain
C) Petechiae, purpura, and signs of organ dysfunction such as decreased urine output and confusion
D) Elevated temperature, tachycardia, and increased appetite
C) Petechiae, purpura, and signs of organ dysfunction such as decreased urine output and confusion
Uncontrolled bleeding, petechiae, purpura (Larger), hematoma, SOB if clots are in lungs, Chest pain if clots are in heart, Abdominal pain, N, V if clots affect GI, cyanosis in fingers and toes.
*If other organs are affected, specific s/s related to the organs
A nurse is assessing a patient suspected of having deep vein thrombosis (DVT). Which of the following combinations of signs and symptoms would be most characteristic of a DVT?
A) Unilateral leg swelling, warmth, and pain in the calf upon dorsiflexion
B) Bilateral leg edema, shortness of breath, and cyanosis
C) Sharp chest pain, coughing, and hemoptysis
D) Fever, generalized malaise, and rash on both legs
A) Unilateral leg swelling, warmth, and pain in the calf upon dorsiflexion (Homan's Sign)
foot moves toward shin
Unilateral edema
Pain
Red or warm skin over affected area
Which assessment finding would be expected in pulmonary embolism (PE)? (Select all that apply.)
A. Chest pain
B. Tachycardia
C. Tachypnea
D. Fever
E. Hemoptysis
A. Chest pain
B. Tachycardia
C. Tachypnea
D. Fever
E. Hemoptysis
Chest pain, dyspnea, tachypnea, tachycardia, anxiety, syncope, hemoptysis, Fever
Fever due to the body targeting an inflammatory response as body attempts to heal damaged area.
A patient with a history of chronic anemia is being assessed in the clinic. Which combination of signs and symptoms should the nurse anticipate as being most indicative of worsening anemia?
A) Fatigue, weakness, and pallor
B) Shortness of breath (SOB), elevated blood pressure, and hyperactivity
C) Dyspnea, tachycardia, and fever
D) Fatigue, weight gain, and increased appetite
A) Fatigue, weakness, and pallor
Fatigue, Weakness, SOB/Dyspnea, and Pallor
A nurse is teaching a group of nursing students about the pathophysiology of disseminated intravascular coagulation (DIC). Which of the following statements accurately describes the underlying mechanisms involved in DIC?
A) DIC primarily results from an increase in clotting factor synthesis, leading to excessive clot formation without bleeding.
B) The widespread activation of coagulation leads to the formation of fibrin clots in small vessels, obstructing blood flow and resulting in multiple organ failure.
C) In DIC, there is decreased platelet consumption, allowing for normal clotting and preventing hemorrhage.
D) The primary mechanism of DIC is the decrease in vascular permeability, which prevents bleeding and promotes tissue perfusion.
B) The widespread activation of coagulation leads to the formation of fibrin clots in small vessels, obstructing blood flow and resulting in multiple organ failure.
Condition where blood becomes overactive leading to widespread clotting in small vessels causing severe bleeding because the body can't form clots where they are needed.
A nurse is reviewing the pathophysiology of deep vein thrombosis (DVT) with a group of nursing students. Which of the following statements accurately describes the pathophysiological mechanisms involved in the development of DVT?
A) DVT occurs primarily due to increased blood flow velocity and reduced coagulability, leading to enhanced fibrinolysis.
B) DVT results from venous stasis, endothelial injury, and hypercoagulability, which together promote thrombus formation in the venous system.
C) The primary cause of DVT is the breakdown of platelets, leading to decreased clot formation in the venous circulation.
D) DVT is mainly associated with arterial occlusion, resulting in tissue ischemia and subsequent thrombus development in the arterial system.
B) DVT results from venous stasis, endothelial injury, and hypercoagulability, which together promote thrombus formation in the venous system.
Blood clot forms in a deep vein, typically in legs
venous stasis- prolonged immobility
endothelial injury-from surgery or trauma
hyper-coagulability- increased clotting tendency
A 70 year old hospitalized for a pelvic fracture develops a pulmonary embolism. The nurse realizes this embolus is most commonly composed of:
A. fat.
B. air.
C. tissue fragment.
D. blood clot.
D. blood clot.
Clot breaks loose and travels to the lungs, usually from DVT
A nursing student is studying the pathophysiology of anemia. Which statement best describes anemia?
A) An increase in the total number of erythrocytes in the circulating blood.
B) A reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin.
C) An increase in the quality and quantity of hemoglobin in the blood.
D) A normal number of erythrocytes with elevated hematocrit levels.
B) A reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin.
Reduction in the total number of erythrocytes in the circulating blood or a decrease in the quality or quantity of hemoglobin.