A client with septic shock develops disseminated intravascular coagulation (DIC). Which pathophysiologic process should the nurse recognize as the cause of the coagulation problem?

Activation of complement pathways.

Inhibition of red blood production.

Production of extra platelets.

Depletion of clotting factors.

Answer and Explanation

The Correct Answer is D

Rationale

A. The complement system is part of the immune response and can be activated in various conditions, including sepsis. However, activation of complement pathways does not directly cause DIC. Instead, in septic shock, the release of pro-inflammatory cytokines and tissue factor can trigger systemic coagulation activation, leading to DIC.

B. Inhibition of red blood cell production, such as in conditions like aplastic anemia or certain types of bone marrow disorders, does not directly cause DIC. DIC is primarily a disorder of excessive activation of clotting factors in response to underlying conditions like sepsis, trauma, or cancer.

C. Production of extra platelets, or thrombocytosis, is not the cause of DIC. Thrombocytosis can occur in response to various conditions, but DIC involves consumption of platelets due to widespread activation of clotting within the vasculature.

D. DIC is characterized by the widespread consumption and depletion of clotting factors and platelets as they are used up in the formation of microthrombi throughout the bloodstream. This depletion leads to an increased risk of bleeding due to insufficient clotting factors remaining to maintain hemostasis.

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Correct Answer is B

Explanation

Rationale

A. JVD is typically an indicator of increased central venous pressure and can be associated with heart failure or fluid overload. In this scenario, flat JVD suggests decreased venous return, which may exacerbate the client's hypotension. While important, it may not be the most immediate concern compared to other options.

B. Changes in consciousness, such as confusion, disorientation, or loss of consciousness, are critical signs that indicate poor cerebral perfusion. In this case, the rapid ventricular rate and possibly inadequate cardiac output may not be meeting cerebral perfusion needs, leading to altered mental status. This finding requires urgent attention to prevent further deterioration.

C. Nausea and vomiting can indicate inadequate perfusion to the gastrointestinal tract due to hypotension or impaired cardiac output. While important to assess for fluid and electrolyte balance, it is less urgent compared to potential changes in mental status or perfusion to vital organs.

D. A sudden onset headache can be indicative of various issues, including hypertension, cerebral ischemia, or intracranial hemorrhage. However, in the context of atrial fibrillation with rapid ventricular response and hypotension, other neurological signs such as altered mental status or focal neurological deficits would typically be more concerning.

A. Keep the nails trimmed short. B. Bathe the child daily with bath oil. C. Apply baby lotion to the skin twice daily. D. Allow the child to wear only 100% cotton clothing.

Correct Answer is A

Explanation

Rationale

A. Children with eczema often scratch their itchy skin, which can lead to skin breakdown, bleeding, and secondary infections. Short nails minimize the trauma inflicted on the skin during scratching and help prevent complications.

B. Bathing helps to hydrate the skin and remove allergens, bacteria, and other irritants that can exacerbate eczema. Bathing daily with bath oil helps to moisturize the skin and prevent dryness. Bath oils or emollients should be used instead of harsh soaps, which can strip the skin of natural oils and worsen dryness. However, it's essential to ensure the water is not too hot and to limit bath time to avoid drying out the skin.

C. Moisturizing the skin is a cornerstone of eczema management. Applying a moisturizer, such as baby lotion or emollient cream, helps to hydrate the skin, reduce dryness, and protect the skin barrier. Moisturizers should ideally be applied at least twice daily, especially after bathing or showering when the skin is damp to lock in moisture. Choosing a moisturizer that is fragrance-free and hypoallergenic is beneficial to avoid further irritation.

D. Cotton clothing is recommended for children with eczema because it is breathable and less likely to irritate sensitive skin compared to synthetic fabrics. Cotton allows better air circulation around the skin, which can help prevent overheating and sweating, both of which can exacerbate eczema symptoms. Avoiding wool and synthetic fabrics that can cause friction and irritation is important.

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A client with septic shock develops disseminated intravascular coagulation (DIC). Which pathophysiologic process should the nurse recognize as the cause of the coagulation problem?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Explanation

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