Which of the following are risk factors for disseminated intravascular coagulation (DIC)? (Select All that Apply.)
Cancer
Sepsis
Trauma
Pregnancy complications
Blood transfusion reactions
Correct Answer : A,B,C,D,E
Choice A Reason:
Cancer is a significant risk factor for DIC, particularly certain types of leukemia and metastatic cancers. Cancer can trigger DIC through the release of procoagulant substances from tumor cells, leading to widespread clotting and subsequent bleeding. The hypercoagulable state associated with malignancies increases the risk of thrombotic events, which can precipitate DIC. Patients with advanced cancer are particularly susceptible due to the aggressive nature of the disease and the body's inflammatory response.
Choice B Reason:
Sepsis is one of the most common causes of DIC. Sepsis triggers a systemic inflammatory response that activates the coagulation cascade, leading to the formation of microthrombi throughout the vasculature. This widespread clotting depletes clotting factors and platelets, resulting in a paradoxical increase in bleeding risk. The severity of sepsis correlates with the likelihood of developing DIC, making early recognition and treatment of sepsis crucial.
Choice C Reason:
Trauma can lead to DIC through extensive tissue injury and the release of tissue factor into the bloodstream. Severe trauma, such as that from major accidents or surgeries, can overwhelm the body's hemostatic mechanisms, leading to uncontrolled clotting and bleeding. The inflammatory response to trauma further exacerbates the coagulation process, increasing the risk of DIC. Prompt management of traumatic injuries and monitoring for signs of DIC are essential in these patients.
Choice D Reason:
Pregnancy complications such as placental abruption, amniotic fluid embolism, and severe preeclampsia can precipitate DIC. These conditions cause significant endothelial damage and the release of procoagulant substances, triggering the coagulation cascade. The physiological changes during pregnancy, including increased blood volume and hypercoagulability, further predispose pregnant women to DIC. Early intervention and management of pregnancy-related complications are vital to prevent DIC.
Choice E Reason:
Blood transfusion reactions can lead to DIC through immune-mediated mechanisms. Incompatible blood transfusions can cause hemolysis and the release of procoagulant substances, initiating the coagulation cascade. The resulting widespread clotting and consumption of clotting factors can lead to bleeding complications. Careful matching of blood products and monitoring for transfusion reactions are critical to prevent DIC in transfusion recipients.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["20"]
Explanation
Step-by-Step Calculation:
Step 1: Identify the prescribed dose.
1000 units per hour
Step 2: Identify the concentration of heparin in the IV bag.
25,000 units in 500 mL
Step 3: Calculate the concentration of heparin per mL.
25,000 units ÷ 500 mL = 50 units/mL
Result = 50 units/mL
Step 4: Calculate the IV pump rate in mL/hr.
1000 units per hour ÷ 50 units/mL = 20 mL/hr
Result = 20 mL/hr
Final Result:
The IV pump should be set to 20 mL/hr.
Correct Answer is B
Explanation
Choice A Reason:
Reduced blood pressure is not a specific complication of infective endocarditis. While hypotension can occur in severe cases due to septic shock, it is not a hallmark of the disease. Infective endocarditis primarily affects the heart valves and can lead to embolic events, heart failure, and other complications.
Choice B Reason:
Osler's nodes are a classic sign of infective endocarditis. These are painful, red or purple, raised lesions found on the hands and feet. They are caused by immune complex deposition and are indicative of the systemic nature of the infection. Their presence can help in the clinical diagnosis of infective endocarditis.
Choice C Reason:
Clear lung sounds are not a complication of infective endocarditis. In fact, clear lung sounds would generally indicate that there is no pulmonary involvement or congestion. Complications of infective endocarditis are more likely to involve the heart, kidneys, and other organs through embolic events.
Choice D Reason:
Increased appetite is not associated with infective endocarditis. Patients with this condition often experience symptoms such as fever, fatigue, and weight loss due to the chronic infection. Increased appetite would be an unusual finding and not related to the disease process.
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