we
as each organ fails, the average risk of death increased ____ to ____ percent
what is 11, 23
pt will be hypoglycemic or hyperglycemic
what is hyperglycemic
2 primary problems caused by DIC are
what is decreased tissue perfusion due to thrombi, anemia, and hypotension leading to organ ischemia and necrosis; hemorrhage, both externally and internally into all body cavities, due to accelerated and inappropriate consumption of clotting factors
if the causative factor is not corrected, clotting continues throughout the body, leading to ________, _________, _________.
what is multi-organ ischemia, infarction, and eventually failure
also known as powerful anticoagulants
what are fibrin degradation products
If a patient is experiencing hypotension, the nurse should remember to treat this first, why?
what is shock can occur with severe hypotension
the condition is often seen in ICUs in its acute form as a complication of ______ _______ and ____ states, as well as _______, _________ reactions, and _______ complications
what is septic shock, shock, septicemia, transfusion, obstetric
Coagulation with thrombosis (microthrombi formation) in vessels and major organs, which may result in what 4 things
what is pulmonary embolism, thrombophlebitis, cerebrovascular accident, and renal failure
depletion of clotting products along with the release of these anticoagulants leads to the _________ _____________.
what is uncontrolled hemorrhage
DIC is diagnosed primarily on ________ ______ and patient ______, with confirmation provided by laboratory findings
what is clinical signs, history
which of the following would a nurse define as a key laboratory finding in DIC?
a. increased PT
b. low platelet count
c. low Hgb
d. increased 02 Sats
what is b
"Low platelet count is a key laboratory finding in DIC; however, it is not a specific feature of DIC and may be seen in other conditions."
what is normal
primary aims of medical management in DIC are to
what is tx the underlying cause, provide supportive management of complications, support organ function, stop abnormal coagulation and control bleeding
what may be given to support organ function and maintain tissue perfusion
what is positive inotropic agents (epi, norepi, dopamine, dobutamine, dig, etc.) and colloid infusions
when is DIC treated as a standalone condition
what is if the coagulation regulatory system becomes overridden and DIC becomes uncontrolled
daily & as required (PRN) _______ studies should be undertaken & ______ ________ levels monitored to indicate the presence of lactic acidosis and the severity of impaired perfusion
what is clotting, arterial lactate
when heparin is used to reduce thrombosis, what may be given first to be infused to replace depleted coagulation factors
what is fresh frozen plasma
a. transfuse blood products only if ongoing bleeding or high risk of bleeding
b. assess for underlying cause of DIC and treat
c. if persistent bleeding, consider use of heparin
d. follow platelets, aPTT/PT, fibrinogen every 4-6 hours or as clinically indicated
e. follow laboratory parameters every 4-6 hours until DIC resolved and underlying condition successfully treatment
f. establish baseline platelet count, PT, aPTT, D-dimer, fibrinogen
what is b, f, a, d, c, e
Which of the following are considered "common causes" of DIC? SATA.
a. extensive burns/trauma
b. severe septic shock
c. neoplastic disease
d. purpura fulminans
e. heatstroke
f. incompatible blood transfusion
g. cardiac arrest
h. use of anesthesia
what is erry single one
4 Ts
what is
- Tissue (retained placenta)
- Tone (uterine atony)
- Traumatic delivery (trauma)
- Thrombin (coagulation disorders)
a. seizures
b. mucosal ischemia
c. hepatic encephalopathy
d. hypoxemia
e. pulmonary hypertension
what is a & c
which of the following are known as causes of acute DIC?
a. multiple bleeding sites
b. bruising of skin, mucous membranes
c. deep vein or arterial thrombosis or embolism
d. serial thrombotic episodes
e. lack of blood supply to tissues (ischemia)
what is a, b, e
weighed for an accurate measurement of blood loss
what is wound dressings and linen
what is myocardial depressant
cardiac output, cardiac index, systemic vascular resistance, oxygen delivery and oxygen consumption should be measured every ____ to _____ hours if a pulmonary artery catheter is in place
what is 6, 12