The nurse admits a client with sepsis and has developed cool ecchymotic fingertips and toes. The healthcare provider determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

Glucosuria and lethargy.

Frothy urine and anorexia.

Hematuria and hemoptysis.

Polyuria and productive cough.

Answer and Explanation

The Correct Answer is C

Disseminated intravascular coagulation (DIC) is a serious condition characterized by widespread activation of coagulation throughout the body, leading to both thrombosis and hemorrhage. Here's why option C is the correct choice:

A) Glucosuria and lethargy:

Glucosuria (presence of glucose in the urine) and lethargy are not typical findings associated with DIC. Glucosuria may indicate diabetes mellitus or renal dysfunction, while lethargy can result from various causes but is not specific to DIC.

B) Frothy urine and anorexia:

Frothy urine may indicate proteinuria, which can occur in conditions such as nephrotic syndrome, but it is not a characteristic finding of DIC. Anorexia (loss of appetite) is a nonspecific symptom that can occur in many conditions but is not directly related to DIC.

C) Hematuria and hemoptysis:

Correct. Hematuria (blood in the urine) and hemoptysis (coughing up blood) are common manifestations of DIC. In DIC, widespread activation of the coagulation cascade can lead to microthrombi formation in small blood vessels, resulting in tissue ischemia and bleeding. Hematuria and hemoptysis can occur due to bleeding from the urinary tract or respiratory system, respectively, as a result of DIC-induced coagulopathy.

D) Polyuria and productive cough:

Polyuria (excessive urination) and productive cough (cough with production of sputum) are not specific findings of DIC. Polyuria may occur in conditions such as diabetes mellitus or diuretic use, while productive cough can be seen in respiratory infections or chronic lung diseases but is not directly related to DIC.

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Correct Answer is D

Explanation

A) Sensory neuropathy:

Sensory neuropathy, while common in diabetes mellitus, primarily affects sensation in the extremities and can lead to reduced pain perception and protective sensation. While sensory neuropathy can contribute to the development of foot ulcers by reducing the ability to detect trauma or pressure, it is not the primary factor influencing the ability of the ulcer to heal.

B) Hyperlipidemia:

Hyperlipidemia, characterized by elevated levels of lipids (cholesterol and triglycerides) in the blood, is a common comorbidity in diabetes mellitus. It can contribute to the development of atherosclerosis and macrovascular complications such as coronary artery disease and peripheral arterial disease. While macrovascular disease can impair wound healing by reducing blood flow to the affected area, it is not the primary contributing factor to the ability of the ulcer to heal.

C) Ketoacidosis:

Ketoacidosis, a serious complication of uncontrolled diabetes mellitus, results from the accumulation of ketones in the blood, leading to metabolic acidosis. While ketoacidosis can have systemic effects and impair overall health, it is not directly related to the ability of a foot ulcer to heal.

D) Microvascular changes:

Correct. Microvascular changes, such as thickening of the capillary basement membrane and endothelial dysfunction, are hallmark features of diabetes mellitus. These changes lead to impaired microcirculation, reduced oxygen delivery, and compromised nutrient supply to tissues, including the skin and soft tissues of the foot. Poor microvascular perfusion contributes to delayed wound healing and an increased risk of infection in individuals with diabetes mellitus. Addressing microvascular changes is essential for promoting wound healing in diabetic foot ulcers, making it the primary contributing factor to the ability of the ulcer to heal.

A. Bronchioles. B. Trachea. C. Bronchi. D. Alveoli.

Correct Answer is D

Explanation

A) Bronchioles:

Bronchioles are small airways in the lungs that lack cartilage and are primarily responsible for conducting air to the alveoli. While changes in bronchioles, such as bronchoconstriction or bronchiolitis, can contribute to airflow limitation in conditions like asthma or chronic bronchitis, they are not primarily associated with the pathophysiological processes of emphysema.

B) Trachea:

The trachea, or windpipe, is the large airway that connects the larynx to the bronchi. It serves as a conduit for air movement into and out of the lungs but is not directly involved in gas exchange. Changes in the trachea are not typically associated with the pathophysiological processes of emphysema.

C) Bronchi:

Bronchi are larger airways in the lungs that branch off from the trachea and further divide into bronchioles. While chronic bronchitis, a common comorbidity of emphysema in chronic obstructive pulmonary disease (COPD), primarily affects the bronchi, it is not the primary structure associated with the pathophysiological processes of emphysema.

D) Alveoli:

Correct. Emphysema is a type of COPD characterized by the destruction of alveolar walls, leading to enlarged airspaces and loss of lung elasticity. This structural damage results in decreased surface area for gas exchange and impaired diffusion of oxygen and carbon dioxide across the alveolar-capillary membrane. Alveolar destruction in emphysema leads to poor gas exchange and contributes to the characteristic symptoms of dyspnea, hypoxemia, and hypercapnia in affected individuals. Therefore, the alveoli are directly associated with the pathophysiological processes of emphysema

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The nurse admits a client with sepsis and has developed cool ecchymotic fingertips and toes. The healthcare provider determines that the client has developed disseminated intravascular coagulation (DIC). Which findings support the pathophysiology of DIC?

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