Nomenclature
What is DIC short for?
Disseminated intravascular coagulation
What is one of the most common causes for DIC that we discussed in lecture?
Sepsis, Trauma, Pregnancy, Trauma
What is the primary focus that is addressed in the nursing care of DIC?
Treating the underlying cause.
What is the normal reference range for platelets?
150,000-400,000 mm3
What solution should blood products only be infused with?
What is PE short for?
Pulmonary embolism
What two things are depleted in widespread microthrombi formation in DIC?
Platelets and clotting factors
Name 1 component of the 1-hour bundle for the management of sepsis.
1. Draw lactate level
2. Obtain blood cultures
3. Administer broad-spectrum antibiotics
4. Rapid fluid administration - 30 mL/kg crystalloid for hypotension/lactate > 4 mmol/L
5. Vasopressor therapy to maintain MAP > 65 mmHg
What lab value (decreased in DIC) has an expected reference range of 14 to 18 g/dL in males and 12 to 16 g/dL in females?
Hemoglobin (Hgb)
What is the antidote for benzodiazepines?
Flumazenil
What is V/Q short for?
Ventilation-perfusion
What is the name of immature neutrophils?
Bands
What is the antidote for heparin?
Protamine sulfate
Which bleeding time blood test would we monitor when administering heparin therapy?
PTT
What two lab values are key to monitor for when it comes to inflammation?
ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein)
What is HIT short for?
Heparin-induced thrombocytopenia
What is the most common cause for a PE?
VTE (venous thromboembolism); DVT (deep-vein thrombosis)
What is the first-line vasopressor when it comes to treating septic shock?
Norepinephrine/Levophed
What lab (increased in DIC and PE; positive) is a global marker of coagulation activation and measures fibrin degradation products (FDP) produced from fibrinolysis?
D-dimer test
These swollen, fragile blood vessels occur as a result of portal hypertension, usually due to cirrhosis of the liver.
Esophageal varices
What is PTT short for?
Partial thromboplastin time
What is known as an increase in the number of bands in a blood sample, indicating bandemia?
Left shift
Name one of the SIRS criteria.
Temperature: < 36 degC or > 38 degC
HR: > 90 beats per minute
RR: > 20 breaths per minute
WBC: > 12,000 or < 4,000; or > 10% bands
What lab value is low in DIC, that necessitates the transfusion of cryoprecipitate?
Fibrinogen
Which congenital heart defect is characterized by a ventricular septal defect, an overriding aorta, pulmonary stenosis, and right ventricular hypertrophy?
Tetralogy of Fallot