A client’s family member asks the nurse why disseminated intravascular coagulation (DIC) occurs. Which statement by the nurse correctly explains the cause of DIC?
DIC is a complication of an autoimmune disease that attacks the body’s own cells
DIC is caused when hemolytic processes destroy erythrocytes
DIC occurs when the immune system attacks platelets and causes massive bleeding
DIC is caused by abnormal activation of the clotting pathway, causing excessive amounts of tiny clots to form inside organs
The Correct Answer is D
Reasoning:
Choice A reason: DIC is not primarily an autoimmune disease complication. While autoimmune conditions may trigger inflammation, DIC results from widespread activation of coagulation pathways due to conditions like sepsis or trauma, leading to microthrombi and factor consumption, not direct autoimmune attack on body cells.
Choice B reason: Hemolytic processes destroying erythrocytes cause hemolytic anemia, not DIC. While hemolysis may contribute to inflammation, DIC is driven by systemic activation of coagulation, forming microthrombi that consume platelets and clotting factors, leading to bleeding, not primarily erythrocyte destruction.
Choice C reason: Immune-mediated platelet destruction occurs in conditions like immune thrombocytopenia, not DIC. DIC involves systemic clotting activation, consuming platelets and factors, causing both thrombosis and bleeding. The immune system does not directly target platelets in DIC’s pathophysiology, making this explanation inaccurate.
Choice D reason: DIC is caused by abnormal activation of the clotting pathway, triggered by conditions like sepsis or trauma, leading to excessive microthrombi formation in organs. This consumes platelets and clotting factors, causing bleeding tendencies.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Reasoning:
Choice A reason: Oral temperature monitoring is important for detecting infection post-surgery but is not the primary concern in transsphenoidal hypophysectomy. Cushing’s syndrome causes hyperglycemia due to cortisol-induced insulin resistance, and surgical stress may exacerbate this, making glucose monitoring more critical than temperature in the perioperative period.
Choice B reason: Weight monitoring is relevant for long-term Cushing’s syndrome management due to fat redistribution, but it is not the most critical during surgery. Perioperative stress and fluid shifts have minimal immediate impact on weight, whereas glucose fluctuations from cortisol changes are more acute and require close monitoring.
Choice C reason: Assessing urine for blood is not a priority in transsphenoidal hypophysectomy. This surgery involves the pituitary gland, not the urinary tract, so hematuria is unlikely. Blood glucose fluctuations, driven by cortisol changes and surgical stress, are a more immediate concern requiring vigilant monitoring.
Choice D reason: Blood glucose monitoring is critical before, during, and after transsphenoidal hypophysectomy. Cushing’s syndrome causes hyperglycemia due to cortisol-induced insulin resistance. Surgery may alter cortisol levels, exacerbating glucose fluctuations, and postoperative adrenal insufficiency risk necessitates close glucose monitoring to manage metabolic complications effectively.
Correct Answer is D
Explanation
Reasoning:
Choice A reason: Diabetes insipidus causes hypernatremia due to excessive water loss from ADH deficiency, leading to polyuria and dehydration. This increases serum sodium concentration, not dilutional hyponatremia, which is characterized by low sodium due to water retention, making DI incorrect for this condition.
Choice B reason: Hypothyroidism affects metabolism through low thyroid hormone levels, causing symptoms like fatigue and weight gain. It does not directly cause dilutional hyponatremia, as it does not involve ADH or water retention. Sodium imbalances in hypothyroidism are rare and not dilutional in nature.
Choice C reason: Hyperthyroidism increases metabolism but does not typically cause dilutional hyponatremia. It may lead to dehydration from increased metabolic demand, but this does not involve excessive water retention or ADH dysfunction, which are necessary for dilutional hyponatremia to occur.
Choice D reason: SIADH causes dilutional hyponatremia due to excessive ADH, leading to water retention in the kidneys. This dilutes serum sodium, lowering its concentration. The increased fluid volume without corresponding sodium retention is the hallmark of SIADH, making it the correct endocrine disorder.
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