A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?

Excessive thrombosis and bleeding

Increased clotting factors

Progressive increase in platelet production

Immediate sodium and fluid retention

Answer and Explanation

The Correct Answer is A

A. Excessive thrombosis and bleeding

Disseminated Intravascular Coagulation (DIC) is a complex and serious condition characterized by widespread activation of the coagulation cascade, leading to both excessive clot formation (thrombosis) and simultaneous consumption of clotting factors and platelets, resulting in bleeding. DIC can occur as a secondary complication to various conditions such as sepsis, trauma, or obstetric complications.

B. Increased clotting factors: In DIC, there is consumption and depletion of clotting factors, not an increase.

C. Progressive increase in platelet production: Platelet production does not increase in DIC; instead, there is consumption and decreased platelet count.

D. Immediate sodium and fluid retention: DIC is not associated with immediate sodium and fluid retention; instead, it is characterized by fluid loss due to bleeding.

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Correct Answer is ["A","C","D"]

Explanation

A. Apply pressure to the nares:

Applying gentle pressure to the nares can help control bleeding.

B. Tilt the client's head backward:

Tilt the head forward slightly to prevent blood from flowing down the back of the throat and to avoid swallowing blood.

C. Place ice to the bridge of the client's nose:

Cold packs can help constrict blood vessels and reduce bleeding.

D. Move the client into high-Fowler's position:

Sitting the client upright in a high-Fowler's position can minimize blood flow to the head and reduce bleeding.

E. Instruct the client to blow his nose:

Blowing the nose may disrupt clots and increase bleeding.

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Correct Answer is C

Explanation

pH 7.22: Indicates acidosis (normal range: 7.35-7.45).

PaCO2 68 mm Hg: Elevated partial pressure of carbon dioxide, suggesting respiratory acidosis (normal range: 35-45 mm Hg).

Base excess -2: Indicates a mild metabolic acidosis.

PaO2 78 mm Hg: Within the normal range (80-100 mm Hg), indicating adequate oxygenation.

Saturation 80%: Below the normal range (95-100%), suggesting some degree of hypoxemia.

Bicarbonate 26 mEq/L: Elevated bicarbonate levels, suggesting metabolic compensation for the respiratory acidosis.

Therefore, the client is experiencing respiratory acidosis with partial metabolic compensation (mild metabolic acidosis).

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A nurse is assessing a client who has disseminated intravascular coagulation (DIC). Which of the following findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has hypertension and develops epistaxis. Which of the following actions should the nurse take? (Select all that apply.)

Correct Answer is ["A","C","D"]

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Correct Answer is C

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