Susan, the nurse, is caring for a client who has DIC. Which of the following medications should the nurse anticipate administering?

Choice A Reason:
Fluid imbalance is a significant concern in burn patients due to the loss of fluids through damaged skin. This can lead to hypovolemic shock if not managed properly. However, while fluid resuscitation is crucial, it is not the immediate priority over airway management in the case of burns to the head and neck. Ensuring the airway is clear and unobstructed takes precedence because airway compromise can lead to rapid deterioration and death.

Choice B Reason:
Airway obstruction is the most critical risk in patients with extensive burns to the head and neck. Burns in these areas can cause swelling, leading to airway compromise. Inhalation injuries from smoke or hot gases can also cause airway edema and respiratory distress. Immediate assessment and intervention to secure the airway are paramount to prevent hypoxia and ensure the patient can breathe adequately. This is why airway management is the top priority in such cases.

Choice C Reason:
Infection is a major risk for burn patients due to the loss of the skin barrier, which normally protects against pathogens. Burn wounds are highly susceptible to bacterial colonization and infection, which can lead to sepsis if not properly managed. While infection control is vital, it is not the immediate priority over securing the airway in the acute phase of burn management. Once the airway is secured, infection prevention and control measures can be implemented.

Choice A: Vitamin K
Vitamin K is essential for the synthesis of clotting factors and is often used to treat bleeding disorders caused by vitamin K deficiency or to reverse the effects of anticoagulants like warfarin. However, in the context of disseminated intravascular coagulation (DIC), the primary issue is not a deficiency of clotting factors but rather an overactivation of the clotting cascade leading to both clot formation and bleeding. Therefore, while vitamin K can be beneficial in certain bleeding disorders, it is not the primary treatment for DIC.

Choice B: Statin
Statins are medications used to lower cholesterol levels and reduce the risk of cardiovascular disease. They work by inhibiting the enzyme HMG-CoA reductase, which plays a crucial role in cholesterol synthesis. Statins are not used in the management of DIC as they do not address the underlying pathophysiology of the condition, which involves widespread clotting and subsequent bleeding.

Choice C: Heparin
Heparin is an anticoagulant that helps prevent the formation of new clots and the extension of existing clots. In the management of DIC, heparin can be used to interrupt the clotting process and prevent further consumption of clotting factors. This can help stabilize the patient and reduce the risk of severe bleeding. Heparin is particularly useful in cases where thrombosis is predominant. It is important to monitor the patient closely to balance the risk of bleeding with the benefits of anticoagulation.

Choice D: Metformin
Metformin is an oral hypoglycemic agent used to manage type 2 diabetes by improving insulin sensitivity and reducing glucose production in the liver. It has no role in the treatment of DIC, as it does not affect the coagulation pathways or the underlying causes of DIC.