The development of acute disseminated intravascular coagulation (DIC) is a critical setback for the patient. The nurse knows that which are common risk factors for the development of acute DIC? Select all that apply.

Intestinal obstruction

Abruptio placenta

Any type of shock

Severe trauma and burns

Sepsis

Answer and Explanation

Correct Answer : B,D,E

A. Intestinal obstruction: Intestinal obstruction alone does not typically trigger the systemic activation of the coagulation cascade required to produce DIC. While severe complications such as bowel ischemia or perforation could potentially lead to sepsis and secondary DIC, uncomplicated obstruction is not considered a common primary risk factor.

B. Abruptio placenta: Abruptio placenta is a well-known obstetric cause of acute DIC. The release of large amounts of tissue factor (thromboplastin) from the damaged placenta into maternal circulation activates the extrinsic coagulation pathway, leading to widespread clot formation and subsequent consumption of clotting factors and platelets.

C. Any type of shock: Not all forms of shock independently cause DIC. While septic shock and prolonged hypoperfusion can contribute to coagulopathy, shock itself is not universally associated with DIC unless accompanied by systemic inflammatory or tissue factor–releasing processes.

D. Severe trauma and burns: Extensive tissue injury from trauma or major burns releases tissue factor into the circulation, activating widespread coagulation. Massive endothelial damage and systemic inflammatory response further amplify clotting cascade activation, predisposing the patient to consumptive coagulopathy and DIC.

E. Sepsis: Sepsis is one of the most common causes of acute DIC. Endotoxins and inflammatory cytokines stimulate systemic coagulation activation and impair natural anticoagulant pathways. This imbalance results in microvascular thrombosis followed by depletion of clotting factors and platelets, leading to bleeding complications.

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Correct Answer is B

Explanation

A. Creatinine clearance: Creatinine clearance reflects glomerular filtration rate and overall kidney function but does not directly indicate the effectiveness of calcium carbonate therapy. Calcium carbonate is prescribed as a phosphate binder, and its efficacy is assessed by changes in serum phosphate rather than kidney filtration rate.

B. Phosphate level: Calcium carbonate binds dietary phosphate in the gastrointestinal tract, reducing absorption and helping to manage hyperphosphatemia, which is common in CKD. Monitoring serum phosphate levels allows the nurse to determine whether the medication is effectively lowering phosphate and preventing complications.

C. Blood pressure: Blood pressure management is important in CKD, but calcium carbonate does not directly influence blood pressure. While hypertension can exacerbate kidney disease, changes in blood pressure are not a reliable indicator of calcium carbonate’s therapeutic effect.

D. Neurologic status: Neurologic changes can occur in severe electrolyte imbalances or uremia, but they are not specific indicators of calcium carbonate effectiveness. Monitoring neurologic status is important for overall patient safety but does not directly reflect phosphate control achieved by the medication.

A. 18 B. 9 C. 27 D. 36

Correct Answer is D

Explanation

To calculate the Total Body Surface Area (TBSA) using the Rule of Nines, you must add the percentages for each specific region burned. According to the chart provided: Each entire leg (anterior and posterior) represents 18% of the total body surface area. The breakdown for one leg is 9% for the anterior (front) and 9% for the posterior (back). Since this client has burns on both the anterior and posterior portions of both legs, the calculation is as follows:

Left Leg (Front 9% + Back 9%) = 18%

Right Leg (Front 9% + Back 9%) = 18%

Total: 18% + 18% = 36%

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The development of acute disseminated intravascular coagulation (DIC) is a critical setback for the patient. The nurse knows that which are common risk factors for the development of acute DIC? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which information will the nurse monitor in order to determine the effectiveness of prescribed calcium carbonate for a patient with chronic kidney disease (CKD)?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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The development of acute disseminated intravascular coagulation (DIC) is a critical setback for the patient. The nurse knows that which are common risk factors for the development of acute DIC? Select all that apply.