A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

Decreased prothrombin time

Increased Hgb level

Increased RBC

Decreased platelet count

Answer and Explanation

The Correct Answer is D

Rationale:

A.   Disseminated intravascular coagulation (DIC) is associated with consumption of clotting factors, leading to prolonged clotting times, such as increased prothrombin time (PT) and activated partial thromboplastin time (aPTT), rather than decreased.
B.   DIC does not typically cause an increase in hemoglobin (Hgb) levels; in fact, it may lead to anemia due to blood loss and consumption of clotting factors.
C.   DIC does not typically cause an increase in red blood cell (RBC) count; if anything, it can lead to anemia due to blood loss.
D.   DIC is characterized by widespread activation of coagulation, leading to consumption of platelets and decreased platelet count, which can result in bleeding tendencies.

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Correct Answer is []

Explanation

Correct Answers:

Condition Most Likely Experiencing: C

Actions to Take: A, B

Parameters to Monitor: B, C

Rationale:

Condition Most Likely Experiencing

A. Pyloric stenosis causes projectile vomiting, dehydration, and hunger.

B. Cystic fibrosis causes chronic respiratory infections, steatorrhea, and failure to thrive.

C. The condition that the infant is most likely experiencing is congestive heart failure, which can cause poor weight gain, tachypnea, decreased appetite, and periorbital edema.

D. Respiratory syncytial virus bronchiolitis causes wheezing, coughing, and respiratory distress.

Actions to Take

A. Elevating the head of the bed can help reduce the workload of the heart and improve breathing.
B. Digoxin can increase the contractility of the heart and decrease the heart rate.

C. Contact precautions are not indicated for congestive heart failure, but for infections that are transmitted by direct or indirect contact.
D. Chest physiotherapy and postural drainage are not indicated for congestive heart failure, but for conditions that cause excessive mucus production and retention.

Parameters to Monitor
A. Number of steatorrhea stools is not relevant for congestive heart failure, but for cystic fibrosis or other malabsorption disorders.
B. Intake and output can indicate fluid balance and renal function.

C. Respiratory status can reflect cardiac function and oxygenation.

D. Presence of periorbital edema is not a parameter to monitor, but a sign of fluid overload.

A. While osteomyelitis is a serious condition requiring treatment, receiving an IV bolus of nafcillin is not an urgent procedure compared to a neurological symptom like slurred speech. B. Pain management is important, but a pain level of 7, while significant, does not indicate an immediate life-threatening situation. C. Slurred speech in an adolescent with sickle cell anemia could indicate a neurological complication or a stroke, which requires immediate assessment and intervention. D. Although the toddler with a partial-thickness burn needs care, it is not as urgent as assessing a potential neurological issue like slurred speech.

Correct Answer is C

Explanation

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A nurse is caring for a child who has disseminated intravascular coagulation. Which of the following laboratory findings should the nurse expect?

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Naxlex Comprehensive Predictor Exams

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Explanation

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