Disseminated Intravascular Coagulation (DIC) is a very complex disorder
It is important for nursing students to learn that DIC is a very complex disorder. You must learn about the risk factors, early signs and symptoms of the disease, and the proper treatment that is needed for early detection to ultimately improve patient outcomes.
Disseminated Intravascular Coagulation (DIC) Overview
Widespread activation of the clotting cascade where the body clots and bleeds, the normal clotting cascade is disrupted, and the clotting factors are used up. This causes severe bleeding and massive hemorrhage.
General Information on Disseminated Intravascular Coagulation (DIC)
Risk Factors – anything that initiates the clotting cascade which then will overreact. The leading cause of DIC is infection.
Nursing Assessment for Disseminated Intravascular Coagulation (DIC)
1. Pallor, dyspnea, chest pain, anxiety, confusion
2. Ecchymosis→ Petechiae, purpura, and hematomas
3. Bleeding from every orifice
4. Abnormal Labs show a prolonged PTT, PT, thrombin time, and↓ Platelets
5. Tachycardia and hypotension
Therapeutic Management for Disseminated Intravascular Coagulation (DIC)
1. Determine and treat underlying cause immediately
2. Replace clotting factors, fresh frozen plasma, vitamin K, factor VII
3. Administer Heparin drip if excessive clotting→This will STOP the consumption of clotting factors
Nursing Case Study for Disseminated Intravascular Coagulation (DIC)
Patient Profile:
Name: Mrs. Jeanne Thompson
Age: 58 years old
Gender: Female
Medical History: Chronic liver disease, sepsis
Presenting Symptoms:
- Prolonged bleeding from venipuncture sites
- Petechiae and purpura
- Hypotension and purpura
- Elevated D-dimer and prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT)
Medical Examination and Diagnostics:
- Physical Examination: Mrs. Thompson displayed sings of widespread bruising and bleeding tendencies
- Laboratory Tests: Elevated D-dimer levels and prolonged clotted times, indicative of DIC
Medical History:
Mrs. Thompson had a known medical history of chronic lever disease, which put her at increased risk of developing DIC, and she presented with sepsis.
Diagnosis:
Mrs. Thompson was diagnosed with disseminated intravascular coagulation (DIC), a serious condition characterized by abnormal and widespread clotting and bleeding.
Treatment Plan:
1. Fluid Resuscitation:
- Initiated aggressive fluid resuscitation to maintain blood pressure and perfusion.
2. Blood Products:
- Administered fresh frozen plasma and platelets to replace depleted clotting factors and correct coagulation abnormalities.
3. Antibiotics:
- Initiated broad-spectrum antibiotics to manage the underlying infection contributing to DIC
4. Monitoring:
- Monitored vital signs, urine output, and laboratory parameters closely to assess treatment response
Outcome:
With vigilant nursing care and timely intervention, Mrs. Thompson’s coagulation abnormalities improved. The administration of blood products and antibiotics helped stabilize her condition. She showed signs of improvement with reduced bleeding tendencies and resolution of petechiae.
Conclusion and Free Download
This Disseminated Intravascular Coagulation (DIC) review provides essential knowledge for approaching the NCLEX with confidence. Understanding its prevention, management, and interventions empowers nurses to provide effective care and save lives.
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