Patho Patho #44

Question

The nurse caring for a client with disseminated intravascular coagulation (DIC) expects which assessment findings:

Answers

  1. 1. Increased platelet levels.
    • Rationale:

      This answer choice is not correct because platelet levels will be decreased, not increased, in clients with DIC due to the excessive clotting that takes place initially.

  2. 2. Unresponsiveness to painful stimuli.
    • Rationale:

      This answer choice is not correct because unresponsiveness to painful stimuli is not an expected outcome in clients with DIC. This would be a sign of a critical potential complication such as a cerebral vascular accident but not an expected manifestation.

  3. 3. Glossitis and cheilitis.
    • Rationale:

      This answer choice is not correct because glossitis and cheilitis are not expected manifestations in clients with DIC. Glossitis and cheilitis are associated with iron deficiency anemia.

  4. 4. Abdominal petechiae.
    • Rationale:

      This answer is correct because abdominal petechiae are expected in a client with DIC due to the breakdown of many microvascular clots.

Overview

The overview of this question is asking the nurse to identify which findings are expected in a client with a diagnosis of disseminated intravascular coagulation (DIC). DIC is a disorder of excessive and abnormal coagulation usually triggered by the inflammatory response. As a result of excessive clotting, there is excessive breakdown of clots which causes bleeding. Abdominal petechiae may be noted on assessment due to internal hemorrhaging.

Explanation

Learning Outcomes

DIC is a disorder caused by abnormal activation of the coagulation cascade. The inflammatory response triggers the clotting cascade abnormally leading to microvascular clots which then triggers the body to begin fibrinolysis. Excessive fibrinolysis leads to signs and symptoms of excessive bleeding including petechiae, purpura, hematuria, or bleeding from the IV site.

Test Taking Tip

Expected manifestation vs. critical potential complication; significant mental status changes are most often associated with potential complications rather than expected manifestations.

Video Rationale