Question 1

The nurse is caring for a client with disseminated intravascular coagulation (DIC). Which should the nurse identify as a priority intervention for this client?

Accepted Answer

A)Impairment of skin integrity can lead to bleeding in DIC. The client with DIC should be placed on bedrest. DIC is not diagnosed with radiograph examination but by serum lab studies. Fluids need to be monitored but will not be restricted.
B)Impairment of skin integrity can lead to bleeding in DIC. The client with DIC should be placed on bedrest. DIC is not diagnosed with radiograph examination but by serum lab studies. Fluids need to be monitored but will not be restricted.
C)Impairment of skin integrity can lead to bleeding in DIC. The client with DIC should be placed on bedrest. DIC is not diagnosed with radiograph examination but by serum lab studies. Fluids need to be monitored but will not be restricted.
D)Impairment of skin integrity can lead to bleeding in DIC. The client with DIC should be placed on bedrest. DIC is not diagnosed with radiograph examination but by serum lab studies. Fluids need to be monitored but will not be restricted.

Question 2

A client with disseminated intravascular coagulation (DIC)has a nursing diagnosis of Ineffective Peripheral Tissue Perfusion. Which actions interventions are appropriate for this diagnosis? Select all that apply.

Accepted Answer

A)Thrombi and emboli forming throughout the microcirculation in DIC affect the perfusion of multiple organs and tissues. The nurse should not elevate the client's knees on the bed or with a pillow because this may impair arterial and venous flow to the lower legs and feet, increasing vascular stasis and the risk for thrombosis. The nurse should monitor the client's level of consciousness and mental status due to the risk of cerebral emboli. Preventing skin trauma reduces the risk for bleeding. The nurse will assess extremity pulses, warmth, and capillary refill, which facilitates the early treatment of impaired perfusion. Position changes facilitate circulation and tissue perfusion and provide an opportunity to assess for purpura, pallor, and bleeding.
B)Thrombi and emboli forming throughout the microcirculation in DIC affect the perfusion of multiple organs and tissues. The nurse should not elevate the client's knees on the bed or with a pillow because this may impair arterial and venous flow to the lower legs and feet, increasing vascular stasis and the risk for thrombosis. The nurse should monitor the client's level of consciousness and mental status due to the risk of cerebral emboli. Preventing skin trauma reduces the risk for bleeding. The nurse will assess extremity pulses, warmth, and capillary refill, which facilitates the early treatment of impaired perfusion. Position changes facilitate circulation and tissue perfusion and provide an opportunity to assess for purpura, pallor, and bleeding.
C)Thrombi and emboli forming throughout the microcirculation in DIC affect the perfusion of multiple organs and tissues. The nurse should not elevate the client's knees on the bed or with a pillow because this may impair arterial and venous flow to the lower legs and feet, increasing vascular stasis and the risk for thrombosis. The nurse should monitor the client's level of consciousness and mental status due to the risk of cerebral emboli. Preventing skin trauma reduces the risk for bleeding. The nurse will assess extremity pulses, warmth, and capillary refill, which facilitates the early treatment of impaired perfusion. Position changes facilitate circulation and tissue perfusion and provide an opportunity to assess for purpura, pallor, and bleeding
D)Thrombi and emboli forming throughout the microcirculation in DIC affect the perfusion of multiple organs and tissues. The nurse should not elevate the client's knees on the bed or with a pillow because this may impair arterial and venous flow to the lower legs and feet, increasing vascular stasis and the risk for thrombosis. The nurse should monitor the client's level of consciousness and mental status due to the risk of cerebral emboli. Preventing skin trauma reduces the risk for bleeding. The nurse will assess extremity pulses, warmth, and capillary refill, which facilitates the early treatment of impaired perfusion. Position changes facilitate circulation and tissue perfusion and provide an opportunity to assess for purpura, pallor, and bleeding.
E)Thrombi and emboli forming throughout the microcirculation in DIC affect the perfusion of multiple organs and tissues. The nurse should not elevate the client's knees on the bed or with a pillow because this may impair arterial and venous flow to the lower legs and feet, increasing vascular stasis and the risk for thrombosis. The nurse should monitor the client's level of consciousness and mental status due to the risk of cerebral emboli. Preventing skin trauma reduces the risk for bleeding. The nurse will assess extremity pulses, warmth, and capillary refill, which facilitates the early treatment of impaired perfusion. Position changes facilitate circulation and tissue perfusion and provide an opportunity to assess for purpura, pallor, and bleeding.

Question 3

The nurse is evaluating care provided to a client with disseminated intravascular coagulation (DIC). Which finding indicates care has been successful for this client?

Accepted Answer

A)Care provided to a client with DIC is successful when there is no further bleeding. Heart rate of 110 beats per minute, oxygen saturation of 86%, and urine output of 20 mL per hour would indicate the need for further treatment.
B)Care provided to a client with DIC is successful when there is no further bleeding. Heart rate of 110 beats per minute, oxygen saturation of 86%, and urine output of 20 mL per hour would indicate the need for further treatment.
C)Care provided to a client with DIC is successful when there is no further bleeding. Heart rate of 110 beats per minute, oxygen saturation of 86%, and urine output of 20 mL per hour would indicate the need for further treatment.
D)Care provided to a client with DIC is successful when there is no further bleeding. Heart rate of 110 beats per minute, oxygen saturation of 86%, and urine output of 20 mL per hour would indicate the need for further treatment.

Question 4

A client with disseminated intravascular coagulation (DIC)is experiencing joint pain. Which nursing intervention is appropriate for this client?

Accepted Answer

A)Joint pain associated with DIC can be reduced by applying cool compresses to the affected joints to reduce the transmission of pain impulses. Splints may hinder joint mobility and are not indicated for the care of this client. Heat will encourage bleeding and should not be applied to this client. Ice should not be applied but rather cool compresses.
B)Joint pain associated with DIC can be reduced by applying cool compresses to the affected joints to reduce the transmission of pain impulses. Splints may hinder joint mobility and are not indicated for the care of this client. Heat will encourage bleeding and should not be applied to this client. Ice should not be applied but rather cool compresses.
C)Joint pain associated with DIC can be reduced by applying cool compresses to the affected joints to reduce the transmission of pain impulses. Splints may hinder joint mobility and are not indicated for the care of this client. Heat will encourage bleeding and should not be applied to this client. Ice should not be applied but rather cool compresses.
D)Joint pain associated with DIC can be reduced by applying cool compresses to the affected joints to reduce the transmission of pain impulses. Splints may hinder joint mobility and are not indicated for the care of this client. Heat will encourage bleeding and should not be applied to this client. Ice should not be applied but rather cool compresses.

Question 5

A client diagnosed with disseminated intravascular coagulation (DIC)is currently bleeding through the gastrointestinal tract. Which does the nurse anticipate administering to this client as a first line treatment?

Accepted Answer

A)When bleeding is the major manifestation of DIC, fresh frozen plasma and platelet concentrates are given first to restore clotting factors and platelets. Aspirin and Coumadin are not indicated in the treatment of DIC. Heparin may be administered if bleeding is not controlled by plasma and platelets and if the client has manifestations of thrombotic problems.
B)When bleeding is the major manifestation of DIC, fresh frozen plasma and platelet concentrates are given to restore clotting factors and platelets. Aspirin and Coumadin are not indicated in the treatment of DIC. Heparin may be administered if bleeding is not controlled by plasma and platelets and if the client has manifestations of thrombotic problems.
C)When bleeding is the major manifestation of DIC, fresh frozen plasma and platelet concentrates are given to restore clotting factors and platelets. Aspirin and Coumadin are not indicated in the treatment of DIC. Heparin may be administered if bleeding is not controlled by plasma and platelets and if the client has manifestations of thrombotic problems.
D)When bleeding is the major manifestation of DIC, fresh frozen plasma and platelet concentrates are given to restore clotting factors and platelets. Aspirin and Coumadin are not indicated in the treatment of DIC. Heparin may be administered if bleeding is not controlled by plasma and platelets and if the client has manifestations of thrombotic problems.

Question 6

Which pathological change related to disseminated intravascular coagulation (DIC)occurs late in the course of the disease?

Accepted Answer

A)Damage to the endothelium is one of the triggers that stimulates the clotting cascade. This increases the presence of thrombin, which causes small clots to form in the microvasculature. If these thrombi and emboli impair tissue perfusion, ischemia of organs such as the brain can occur. When clotting factors are depleted and fibrin degradation products are released, hemorrhage occurs.
B)Damage to the endothelium is one of the triggers that stimulates the clotting cascade. This increases the presence of thrombin, which causes small clots to form in the microvasculature. If these thrombi and emboli impair tissue perfusion, ischemia of organs such as the brain can occur. When clotting factors are depleted and fibrin degradation products are released, hemorrhage occurs.
C)Damage to the endothelium is one of the triggers that stimulates the clotting cascade. This increases the presence of thrombin, which causes small clots to form in the microvasculature. If these thrombi and emboli impair tissue perfusion, ischemia of organs such as the brain can occur. When clotting factors are depleted and fibrin degradation products are released, hemorrhage occurs.
D)Damage to the endothelium is one of the triggers that stimulates the clotting cascade. This increases the presence of thrombin, which causes small clots to form in the microvasculature. If these thrombi and emboli impair tissue perfusion, ischemia of organs such as the brain can occur. When clotting factors are depleted and fibrin degradation products are released, hemorrhage occurs.

Question 7

A client with disseminated intravascular coagulation (DIC)has a nursing diagnosis of Impaired Gas Exchange. Which action is appropriate when providing care based on this nursing diagnosis?

Accepted Answer

A)Micro clots in the pulmonary vasculature are likely to interfere with gas exchange in the client with DIC. The nurse should place the client in Fowler or high-Fowler position to improve gas exchange. Oxygen saturation levels are a noninvasive means of assessing gas exchange and should be monitored continuously. The client must remain on bedrest to reduces oxygen demands and cardiac workload. Cautious nasotracheal suctioning is indicated only if cough is ineffective or an endotracheal tube is in place. Deep breathing increases respiratory depth and improves alveolar ventilation and oxygenation.
B)Micro clots in the pulmonary vasculature are likely to interfere with gas exchange in the client with DIC. The nurse should place the client in Fowler or high-Fowler position to improve gas exchange. Oxygen saturation levels are a noninvasive means of assessing gas exchange and should be monitored continuously. The client must remain on bedrest to reduces oxygen demands and cardiac workload. Cautious nasotracheal suctioning is indicated only if cough is ineffective or an endotracheal tube is in place. Deep breathing increases respiratory depth and improves alveolar ventilation and oxygenation.
C)Micro clots in the pulmonary vasculature are likely to interfere with gas exchange in the client with DIC. The nurse should place the client in Fowler or high-Fowler position to improve gas exchange. Oxygen saturation levels are a noninvasive means of assessing gas exchange and should be monitored continuously. The client must remain on bedrest to reduces oxygen demands and cardiac workload. Cautious nasotracheal suctioning is indicated only if cough is ineffective or an endotracheal tube is in place. Deep breathing increases respiratory depth and improves alveolar ventilation and oxygenation.
D)Micro clots in the pulmonary vasculature are likely to interfere with gas exchange in the client with DIC. The nurse should place the client in Fowler or high-Fowler position to improve gas exchange. Oxygen saturation levels are a noninvasive means of assessing gas exchange and should be monitored continuously. The client must remain on bedrest to reduces oxygen demands and cardiac workload. Cautious nasotracheal suctioning is indicated only if cough is ineffective or an endotracheal tube is in place. Deep breathing increases respiratory depth and improves alveolar ventilation and oxygenation.

Question 8

The three pathological factors that are associated with the formation of a thrombus are known as what?

Accepted Answer

A)Three pathological factors, called Virchow's triad, are associated with the formation of a thrombus: circulatory stasis, vascular damage, and hypercoagulability. The Rastelli procedure is used to repair some congenital heart defects. A Holter monitor is used record the electrical activity of the heart over 24 to 48 hours. A vena cava filter is used to prevent thrombi from traveling up to the heart from the legs.
B)Three pathological factors, called Virchow's triad, are associated with the formation of a thrombus: circulatory stasis, vascular damage, and hypercoagulability. The Rastelli procedure is used to repair some congenital heart defects. A Holter monitor is used record the electrical activity of the heart over 24 to 48 hours. A vena cava filter is used to prevent thrombi from traveling up to the heart from the legs
C)Three pathological factors, called Virchow's triad, are associated with the formation of a thrombus: circulatory stasis, vascular damage, and hypercoagulability. The Rastelli procedure is used to repair some congenital heart defects. A Holter monitor is used record the electrical activity of the heart over 24 to 48 hours. A vena cava filter is used to prevent thrombi from traveling up to the heart from the legs.
D)Three pathological factors, called Virchow's triad, are associated with the formation of a thrombus: circulatory stasis, vascular damage, and hypercoagulability. The Rastelli procedure is used to repair some congenital heart defects. A Holter monitor is used record the electrical activity of the heart over 24 to 48 hours. A vena cava filter is used to prevent thrombi from traveling up to the heart from the legs.

Question 9

A client with disseminated intravascular coagulation (DIC)is anxious and has decreased oxygen saturation. Which is the priority nursing diagnosis for this client?

Accepted Answer

A)The decrease in oxygen saturation is a result of impairment in the client's gas exchange. Anxiety could contribute to the client's impaired gas exchange but is not the primary problem to address. Decreased oxygen saturation and anxiety would not be addressed with the diagnoses of Ineffective Peripheral Tissue Perfusion and Acute Pain.
B)The decrease in oxygen saturation is a result of impairment in the client's gas exchange. Anxiety could contribute to the client's impaired gas exchange but is not the primary problem to address. Decreased oxygen saturation and anxiety would not be addressed with the diagnoses of Ineffective Peripheral Tissue Perfusion and Acute Pain.
C)The decrease in oxygen saturation is a result of impairment in the client's gas exchange. Anxiety could contribute to the client's impaired gas exchange but is not the primary problem to address. Decreased oxygen saturation and anxiety would not be addressed with the diagnoses of Ineffective Peripheral Tissue Perfusion and Acute Pain.
D)The decrease in oxygen saturation is a result of impairment in the client's gas exchange. Anxiety could contribute to the client's impaired gas exchange but is not the primary problem to address. Decreased oxygen saturation and anxiety would not be addressed with the diagnoses of Ineffective Peripheral Tissue Perfusion and Acute Pain.

Question 10

A nurse is assessing a client during labor and delivery. Which condition should the nurse recognize as a risk factor for disseminated intravascular coagulation (DIC)?

Accepted Answer

A)Acute DIC can occur in pregnant clients, most often with pregnancies complicated by preeclampsia, placental abruption, fetal demise, amniotic fluid embolism, and septic abortion. Gestational diabetes, polyhydramnios, and placenta previa are not risk factors for DIC.
B)Acute DIC can occur in pregnant clients, most often with pregnancies complicated by preeclampsia, placental abruption, fetal demise, amniotic fluid embolism, and septic abortion. Gestational diabetes, polyhydramnios, and placenta previa are not risk factors for DIC.
C)Acute DIC can occur in pregnant clients, most often with pregnancies complicated by preeclampsia, placental abruption, fetal demise, amniotic fluid embolism, and septic abortion. Gestational diabetes, polyhydramnios, and placenta previa are not risk factors for DIC.
D)Acute DIC can occur in pregnant clients, most often with pregnancies complicated by preeclampsia, placental abruption, fetal demise, amniotic fluid embolism, and septic abortion. Gestational diabetes, polyhydramnios, and placenta previa are not risk factors for DIC.

Question 11

A client receiving heparin therapy for deep venous thrombosis (DVT)complains of severe chest pain and shortness of breath. Suspecting a pulmonary embolism, which is the priority action by the nurse?

Accepted Answer

A)Applying oxygen and elevating the head of the bed will promote ventilation and gas exchange in those alveoli that are well perfused, helping to maintain tissue oxygenation. Assessing pulse, respiration, and blood pressure will be performed following the initiation of oxygen therapy and bed elevation. Although reassuring the client and notifying family members are important, they are not a higher priority than promoting oxygenation. Increasing the rate of heparin infusion cannot be done by the nurse without an order from a healthcare provider.
B)Applying oxygen and elevating the head of the bed will promote ventilation and gas exchange in those alveoli that are well perfused, helping to maintain tissue oxygenation. Assessing pulse, respiration, and blood pressure will be performed following the initiation of oxygen therapy and bed elevation. Although reassuring the client and notifying family members are important, they are not a higher priority than promoting oxygenation. Increasing the rate of heparin infusion cannot be done by the nurse without an order from a healthcare provider.
C)Applying oxygen and elevating the head of the bed will promote ventilation and gas exchange in those alveoli that are well perfused, helping to maintain tissue oxygenation. Assessing pulse, respiration, and blood pressure will be performed following the initiation of oxygen therapy and bed elevation. Although reassuring the client and notifying family members are important, they are not a higher priority than promoting oxygenation. Increasing the rate of heparin infusion cannot be done by the nurse without an order from a healthcare provider.
D)Applying oxygen and elevating the head of the bed will promote ventilation and gas exchange in those alveoli that are well perfused, helping to maintain tissue oxygenation. Assessing pulse, respiration, and blood pressure will be performed following the initiation of oxygen therapy and bed elevation. Although reassuring the client and notifying family members are important, they are not a higher priority than promoting oxygenation. Increasing the rate of heparin infusion cannot be done by the nurse without an order from a healthcare provider.

Question 12

What is the most accurate tool for assessing and diagnosing venous thrombosis?

Accepted Answer

A)All four of these diagnostic tests can be used to help diagnose a venous thrombosis. However, ascending contrast venography is the only invasive test, and it is the most accurate diagnostic tool for venous thrombosis. The other tests are noninvasive and may not be able to directly visualize the clot.
B)All four of these diagnostic tests can be used to help diagnose a venous thrombosis. However, ascending contrast venography is the only invasive test, and it is the most accurate diagnostic tool for venous thrombosis. The other tests are noninvasive and may not be able to directly visualize the clot.
C)All four of these diagnostic tests can be used to help diagnose a venous thrombosis. However, ascending contrast venography is the only invasive test, and it is the most accurate diagnostic tool for venous thrombosis. The other tests are noninvasive and may not be able to directly visualize the clot.
D)All four of these diagnostic tests can be used to help diagnose a venous thrombosis. However, ascending contrast venography is the only invasive test, and it is the most accurate diagnostic tool for venous thrombosis. The other tests are noninvasive and may not be able to directly visualize the clot.

Question 13

A client is admitted to the intensive care unit with disseminated intravascular coagulation (DIC). Which clinical manifestations does the nurse anticipate? Select all that apply.

Accepted Answer

A)Clinical manifestations of DIC include tachycardia, decreased breath sounds, and confusion. Increased blood glucose and thick bronchial secretions are not associated with this health problem.
B)Clinical manifestations of DIC include tachycardia, decreased breath sounds, and confusion. Increased blood glucose and thick bronchial secretions are not associated with this health problem.
C)Clinical manifestations of DIC include tachycardia, decreased breath sounds, and confusion. Increased blood glucose and thick bronchial secretions are not associated with this health problem.
D)Clinical manifestations of DIC include tachycardia, decreased breath sounds, and confusion. Increased blood glucose and thick bronchial secretions are not associated with this health problem.
E)Clinical manifestations of DIC include tachycardia, decreased breath sounds, and confusion. Increased blood glucose and thick bronchial secretions are not associated with this health problem.

Question 14

The nurse is caring for a client with congestive heart failure (CHF)who frequently wakes during the night frightened and short of breath. Based on this data, what is the client experiencing?

Accepted Answer

A)Paroxysmal nocturnal dyspnea occurs when edema fluid that has accumulated during the day is reabsorbed into the circulation at night. This causes fluid overload and pulmonary congestion. The client awakens at night short of breath and frightened. The client is not experiencing cardiomyopathy, high-output failure, or multisystem heart failure.
B)Paroxysmal nocturnal dyspnea occurs when edema fluid that has accumulated during the day is reabsorbed into the circulation at night. This causes fluid overload and pulmonary congestion. The client awakens at night short of breath and frightened. The client is not experiencing cardiomyopathy, high-output failure, or multisystem heart failure.
C)Paroxysmal nocturnal dyspnea occurs when edema fluid that has accumulated during the day is reabsorbed into the circulation at night. This causes fluid overload and pulmonary congestion. The client awakens at night short of breath and frightened. The client is not experiencing cardiomyopathy, high-output failure, or multisystem heart failure.
D)Paroxysmal nocturnal dyspnea occurs when edema fluid that has accumulated during the day is reabsorbed into the circulation at night. This causes fluid overload and pulmonary congestion. The client awakens at night short of breath and frightened. The client is not experiencing cardiomyopathy, high-output failure, or multisystem heart failure.

Question 15

What characteristic of veins increases the risk for the development of a thrombus?

Accepted Answer

A)Venous thrombi tend to occur at sites where the vein is normal but blood flow is low. High pressure in the veins does not stimulate the formation of a thrombus. Retrograde blood flow is associated with postthrombotic syndrome, which occurs after a deep vein thrombosis has already developed. Arterial thrombi tend to occur at sites of arterial plaque rupture.
B)Venous thrombi tend to occur at sites where the vein is normal but blood flow is low. High pressure in the veins does not stimulate the formation of a thrombus. Retrograde blood flow is associated with postthrombotic syndrome, which occurs after a deep vein thrombosis has already developed. Arterial thrombi tend to occur at sites of arterial plaque rupture.
C)Venous thrombi tend to occur at sites where the vein is normal but blood flow is low. High pressure in the veins does not stimulate the formation of a thrombus. Retrograde blood flow is associated with postthrombotic syndrome, which occurs after a deep vein thrombosis has already developed. Arterial thrombi tend to occur at sites of arterial plaque rupture.
D)Venous thrombi tend to occur at sites where the vein is normal but blood flow is low. High pressure in the veins does not stimulate the formation of a thrombus. Retrograde blood flow is associated with postthrombotic syndrome, which occurs after a deep vein thrombosis has already developed. Arterial thrombi tend to occur at sites of arterial plaque rupture.

Question 16

The nurse has identified Ineffective Peripheral Tissue Perfusion as a nursing diagnosis for a client with disseminated intravascular coagulation (DIC). What intervention would be appropriate for the client?

Accepted Answer

A)The intervention appropriate for the client experiencing ineffective peripheral tissue perfusion is to carefully reposition the client every 2 hours because position changes facilitate circulation and tissue perfusion. The other interventions would be appropriate if the client were experiencing impaired gas exchange.
B)The intervention appropriate for the client experiencing ineffective tissue perfusion is to carefully reposition the client every 2 hours because position changes facilitate circulation and tissue perfusion. The other interventions would be appropriate if the client were experiencing impaired gas exchange.
C)The intervention appropriate for the client experiencing ineffective tissue perfusion is to carefully reposition the client every 2 hours because position changes facilitate circulation and tissue perfusion. The other interventions would be appropriate if the client were experiencing impaired gas exchange.
D)The intervention appropriate for the client experiencing ineffective tissue perfusion is to carefully reposition the client every 2 hours because position changes facilitate circulation and tissue perfusion. The other interventions would be appropriate if the client were experiencing impaired gas exchange.

Question 17

A client being treated for a deep venous thrombosis (DVT)is experiencing pain. Which interventions should the nurse implement? Select all that apply.

Accepted Answer

A)Interventions to address pain include applying warm moist heat to the area four times a day, maintaining bedrest as ordered, and measuring calf and thigh diameter daily. Applying an egg-crate mattress on the bed and encouraging position changes every 2 hours would be appropriate for the client experiencing Ineffective Peripheral Tissue Perfusion.
B)Interventions to address pain include applying warm moist heat to the area four times a day, maintaining bedrest as ordered, and measuring calf and thigh diameter daily. Applying an egg-crate mattress on the bed and encouraging position changes every 2 hours would be appropriate for the client experiencing Ineffective Peripheral Tissue Perfusion.
C)Interventions to address pain include applying warm moist heat to the area four times a day, maintaining bedrest as ordered, and measuring calf and thigh diameter daily. Applying an egg-crate mattress on the bed and encouraging position changes every 2 hours would be appropriate for the client experiencing Ineffective Peripheral Tissue Perfusion.
D)Interventions to address pain include applying warm moist heat to the area four times a day, maintaining bedrest as ordered, and measuring calf and thigh diameter daily. Applying an egg-crate mattress on the bed and encouraging position changes every 2 hours would be appropriate for the client experiencing Ineffective Peripheral Tissue Perfusion.
E)Interventions to address pain include applying warm moist heat to the area four times a day, maintaining bedrest as ordered, and measuring calf and thigh diameter daily. Applying an egg-crate mattress on the bed and encouraging position changes every 2 hours would be appropriate for the client experiencing Ineffective Peripheral Tissue Perfusion.

Question 18

A nurse caring for a client with suspected disseminated intravascular coagulation (DIC). Which test result is common in DIC?

Accepted Answer

A)Diagnostic tests are used to confirm the diagnosis of DIC and evaluate the risk for hemorrhage. DIC causes prolonged prothrombin and partial thromboplastin times due to the depletion of clotting factors. Decreased fibrinogen occurs in DIC, also due to decreased clotting factors. Platelet count is also decreased.
B)Diagnostic tests are used to confirm the diagnosis of DIC and evaluate the risk for hemorrhage. DIC causes prolonged prothrombin and partial thromboplastin times due to the depletion of clotting factors. Decreased fibrinogen occurs in DIC, also due to decreased clotting factors. Platelet count is also decreased.
C)Diagnostic tests are used to confirm the diagnosis of DIC and evaluate the risk for hemorrhage. DIC causes prolonged prothrombin and partial thromboplastin times due to the depletion of clotting factors. Decreased fibrinogen occurs in DIC, also due to decreased clotting factors. Platelet count is also decreased.
D)Diagnostic tests are used to confirm the diagnosis of DIC and evaluate the risk for hemorrhage. DIC causes prolonged prothrombin and partial thromboplastin times due to the depletion of clotting factors. Decreased fibrinogen occurs in DIC, also due to decreased clotting factors. Platelet count is also decreased.

Question 19

Both a 40-year-old male and a 70-year-old male are placed on anticoagulant therapy after diagnosis of a deep vein thrombosis (DVT). When providing teaching to these clients about their medication, how should the nurse individualize care for each?

Accepted Answer

A)Anticoagulant therapy is commonly used to treat both older and younger adults with DVT. Most drugs are administered in a similar fashion and at comparable doses in older and younger clients, but monitoring may occur more frequently in older adults.
B)Anticoagulant therapy is commonly used to treat both older and younger adults with DVT. Most drugs are administered in a similar fashion and at comparable doses in older and younger clients, but monitoring may occur more frequently in older adults.
C)Anticoagulant therapy is commonly used to treat both older and younger adults with DVT. Most drugs are administered in a similar fashion and at comparable doses in older and younger clients, but monitoring may occur more frequently in older adults.
D)Anticoagulant therapy is commonly used to treat both older and younger adults with DVT. Most drugs are administered in a similar fashion and at comparable doses in older and younger clients, but monitoring may occur more frequently in older adults.

Question 20

The nurse is caring for a client who has been admitted to labor and delivery. What should the nurse recognize as risk factors for disseminating intravascular coagulation (DIC)? Select all that apply.

Accepted Answer

A)The risk of developing DIC increases in pregnant women who have preeclampsia, fetal death, amniotic fluid embolism, placental abruption, or septic abortion. Multiparity, preterm labor, and gestational diabetes do not cause DIC.
B)The risk of developing DIC increases in pregnant women who have preeclampsia, fetal death, amniotic fluid embolism, placental abruption, or septic abortion. Multiparity, preterm labor, and gestational diabetes do not cause DIC.
C)The risk of developing DIC increases in pregnant women who have preeclampsia, fetal death, amniotic fluid embolism, placental abruption, or septic abortion. Multiparity, preterm labor, and gestational diabetes do not cause DIC.
D)The risk of developing DIC increases in pregnant women who have preeclampsia, fetal death, amniotic fluid embolism, placental abruption, or septic abortion. Multiparity, preterm labor, and gestational diabetes do not cause DIC.
E)The risk of developing DIC increases in pregnant women who have preeclampsia, fetal death, amniotic fluid embolism, placental abruption, or septic abortion. Multiparity, preterm labor, and gestational diabetes do not cause DIC.

Quiz 16: Perfusion

The nurse is caring for a client with disseminated intravascular coagulation (DIC) . Which should the nurse identify as a priority intervention for this client?

A client with disseminated intravascular coagulation (DIC) has a nursing diagnosis of Ineffective Peripheral Tissue Perfusion. Which actions interventions are appropriate for this diagnosis? Select all that apply.

The nurse is evaluating care provided to a client with disseminated intravascular coagulation (DIC) . Which finding indicates care has been successful for this client?

A client with disseminated intravascular coagulation (DIC) is experiencing joint pain. Which nursing intervention is appropriate for this client?

A client diagnosed with disseminated intravascular coagulation (DIC) is currently bleeding through the gastrointestinal tract. Which does the nurse anticipate administering to this client as a first line treatment?

Which pathological change related to disseminated intravascular coagulation (DIC) occurs late in the course of the disease?

A client with disseminated intravascular coagulation (DIC) has a nursing diagnosis of Impaired Gas Exchange. Which action is appropriate when providing care based on this nursing diagnosis?

The three pathological factors that are associated with the formation of a thrombus are known as what?

A client with disseminated intravascular coagulation (DIC) is anxious and has decreased oxygen saturation. Which is the priority nursing diagnosis for this client?

A nurse is assessing a client during labor and delivery. Which condition should the nurse recognize as a risk factor for disseminated intravascular coagulation (DIC) ?

A client receiving heparin therapy for deep venous thrombosis (DVT) complains of severe chest pain and shortness of breath. Suspecting a pulmonary embolism, which is the priority action by the nurse?

What is the most accurate tool for assessing and diagnosing venous thrombosis?

A client is admitted to the intensive care unit with disseminated intravascular coagulation (DIC) . Which clinical manifestations does the nurse anticipate? Select all that apply.

The nurse is caring for a client with congestive heart failure (CHF) who frequently wakes during the night frightened and short of breath. Based on this data, what is the client experiencing?

What characteristic of veins increases the risk for the development of a thrombus?

The nurse has identified Ineffective Peripheral Tissue Perfusion as a nursing diagnosis for a client with disseminated intravascular coagulation (DIC) . What intervention would be appropriate for the client?

A client being treated for a deep venous thrombosis (DVT) is experiencing pain. Which interventions should the nurse implement? Select all that apply.

A nurse caring for a client with suspected disseminated intravascular coagulation (DIC) . Which test result is common in DIC?

Both a 40-year-old male and a 70-year-old male are placed on anticoagulant therapy after diagnosis of a deep vein thrombosis (DVT) . When providing teaching to these clients about their medication, how should the nurse individualize care for each?

The nurse is caring for a client who has been admitted to labor and delivery. What should the nurse recognize as risk factors for disseminating intravascular coagulation (DIC) ? Select all that apply.