The nurse is preparing to educate a group of students on the signs and symptoms of disseminated intravascular coagulation (DIC). The nurse knows that teaching was effective when the students are able to recognize which symptoms as being associated with DIC? (Select all that apply)

Decreased mentation

Increased urine output

Fever

Dyspnea

Six-second capillary refill

Answer and Explanation

Correct Answer : A,C,D,E

Choice A reason: Decreased mentation is a DIC symptom, as microthrombi impair cerebral perfusion, and bleeding may cause hypovolemia, reducing oxygen delivery to the brain. Hypoxia and metabolic disturbances from organ dysfunction further contribute to confusion or altered consciousness, making this a key clinical sign of severe DIC.

Choice B reason: Increased urine output is not typical in DIC. Microthrombi and hypovolemia from bleeding reduce renal perfusion, leading to oliguria or acute kidney injury. Increased urine output occurs in conditions like diabetes insipidus, not DIC, where renal compromise is common due to microvascular clotting and shock.

Choice C reason: Fever is common in DIC, often due to underlying triggers like sepsis or inflammation, which activate the clotting cascade. Cytokine release in these conditions elevates body temperature. Fever reflects the systemic inflammatory response, making it a frequent symptom in DIC, especially when infection is the precipitating cause.

Choice D reason: Dyspnea occurs in DIC due to pulmonary microthrombi impairing gas exchange, leading to hypoxia. Hemorrhage into alveoli or pulmonary edema from organ dysfunction may also contribute. Respiratory distress is a critical symptom, reflecting lung involvement in DIC’s microvascular clotting, requiring urgent intervention to restore oxygenation.

Choice E reason: Six-second capillary refill indicates poor perfusion, common in DIC due to hypovolemia from bleeding and microthrombi obstructing peripheral circulation. Prolonged refill reflects shock or vascular compromise, a key sign of DIC’s systemic impact, necessitating immediate treatment to address coagulopathy and restore hemodynamic stability.

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Correct Answer is ["A"]

Explanation

Choice A reason: Deep and fast respirations (Kussmaul respirations) are a hallmark of DKA, a compensatory mechanism for metabolic acidosis. Excess ketones lower blood pH, triggering rapid, deep breathing to eliminate carbon dioxide, reducing acidity. This respiratory response is a direct physiological attempt to correct the acid-base imbalance caused by ketogenesis in DKA.

Choice B reason: Fruity breath results from acetone, a ketone byproduct in DKA. During uncontrolled hyperglycemia, the body breaks down fats, producing ketones like acetone, which are exhaled, causing a sweet, fruity odor. This is a classic sign of DKA, reflecting the metabolic shift to ketogenesis due to insulin deficiency.

Choice C reason: Decreased urine output is not typical in DKA. Hyperglycemia causes osmotic diuresis, increasing urine output due to glucose pulling water into the urine. This leads to dehydration, not oliguria. Decreased urine output may occur in severe dehydration but is not a primary manifestation of DKA compared to polyuria.

Choice D reason: Dependent pulmonary crackles are not associated with DKA. Crackles indicate fluid overload or pulmonary edema, seen in conditions like heart failure. DKA causes dehydration due to osmotic diuresis, not fluid accumulation in the lungs. Respiratory symptoms in DKA are limited to Kussmaul respirations, not crackles, which are unrelated to its pathophysiology.

Choice E reason: Polydipsia is a classic DKA symptom. Hyperglycemia causes osmotic diuresis, leading to dehydration. The body responds with increased thirst (polydipsia) to compensate for fluid loss. This, along with polyuria and polyphagia, reflects the body’s attempt to counteract the effects of uncontrolled glucose levels and dehydration in DKA.

A. Place affected extremity in a dependent position B. Provide graduated compression stockings C. Do not massage affected limb D. Analgesic agents for pain relief

Correct Answer is A

Explanation

Choice A reason: Placing the affected extremity in a dependent position is contraindicated in DVT, as it promotes blood pooling, worsening clot formation and risking embolism. Elevation reduces swelling and improves venous return, preventing further thrombosis. This action contradicts standard DVT management, which prioritizes reducing stasis and promoting circulation to prevent complications.

Choice B reason: Graduated compression stockings are standard in DVT management, as they improve venous return, reduce edema, and prevent clot progression. By applying external pressure, they counteract venous stasis, a key factor in DVT. This intervention is appropriate and expected to support circulation and reduce complications in affected limbs.

Choice C reason: Avoiding massage of the affected limb is critical in DVT care. Massage can dislodge a clot, leading to pulmonary embolism, a life-threatening complication. This precaution is a standard order to ensure patient safety, as mechanical manipulation of the clot risks embolization and severe cardiovascular consequences.

Choice D reason: Analgesic agents are appropriate for DVT to manage pain caused by inflammation and swelling in the affected limb. Pain relief improves patient comfort and mobility, supporting recovery. Nonsteroidal anti-inflammatory drugs or other analgesics are commonly prescribed, making this an expected and appropriate part of the care plan.

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The nurse is preparing to educate a group of students on the signs and symptoms of disseminated intravascular coagulation (DIC). The nurse knows that teaching was effective when the students are able to recognize which symptoms as being associated with DIC? (Select all that apply)

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A nurse assesses a patient who is experiencing diabetic ketoacidosis (DKA). Which manifestations would the nurse correlate with DKA? (Select all that apply)

Correct Answer is ["A"]

Explanation

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Correct Answer is A

Explanation

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