Which of the following are risk factors for disseminated intravascular coagulation (DIC)? (Select All that Apply.)

Cancer

Sepsis

Trauma

Pregnancy complications

Blood transfusion reactions

Answer and Explanation

Correct Answer : A,B,C,D,E

Choice A Reason:
Cancer is a significant risk factor for DIC, particularly certain types of leukemia and metastatic cancers. Cancer can trigger DIC through the release of procoagulant substances from tumor cells, leading to widespread clotting and subsequent bleeding. The hypercoagulable state associated with malignancies increases the risk of thrombotic events, which can precipitate DIC. Patients with advanced cancer are particularly susceptible due to the aggressive nature of the disease and the body's inflammatory response.

Choice B Reason:
Sepsis is one of the most common causes of DIC. Sepsis triggers a systemic inflammatory response that activates the coagulation cascade, leading to the formation of microthrombi throughout the vasculature. This widespread clotting depletes clotting factors and platelets, resulting in a paradoxical increase in bleeding risk. The severity of sepsis correlates with the likelihood of developing DIC, making early recognition and treatment of sepsis crucial.

Choice C Reason:
Trauma can lead to DIC through extensive tissue injury and the release of tissue factor into the bloodstream. Severe trauma, such as that from major accidents or surgeries, can overwhelm the body's hemostatic mechanisms, leading to uncontrolled clotting and bleeding. The inflammatory response to trauma further exacerbates the coagulation process, increasing the risk of DIC. Prompt management of traumatic injuries and monitoring for signs of DIC are essential in these patients.

Choice D Reason:
Pregnancy complications such as placental abruption, amniotic fluid embolism, and severe preeclampsia can precipitate DIC. These conditions cause significant endothelial damage and the release of procoagulant substances, triggering the coagulation cascade. The physiological changes during pregnancy, including increased blood volume and hypercoagulability, further predispose pregnant women to DIC. Early intervention and management of pregnancy-related complications are vital to prevent DIC.

Choice E Reason:
Blood transfusion reactions can lead to DIC through immune-mediated mechanisms. Incompatible blood transfusions can cause hemolysis and the release of procoagulant substances, initiating the coagulation cascade. The resulting widespread clotting and consumption of clotting factors can lead to bleeding complications. Careful matching of blood products and monitoring for transfusion reactions are critical to prevent DIC in transfusion recipients.

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Correct Answer is ["20"]

Explanation

Step-by-Step Calculation:

Step 1: Identify the prescribed dose.

1000 units per hour

Step 2: Identify the concentration of heparin in the IV bag.

25,000 units in 500 mL

Step 3: Calculate the concentration of heparin per mL.

25,000 units ÷ 500 mL = 50 units/mL

Result = 50 units/mL

Step 4: Calculate the IV pump rate in mL/hr.

1000 units per hour ÷ 50 units/mL = 20 mL/hr

Result = 20 mL/hr

Final Result:

The IV pump should be set to 20 mL/hr.

A. Maintain the cervical collar in place. B. Ask the client if they remember any events around the time of the injury. C. Explain to the client that they will never be able to walk again. D. Notify the client's parents that they are in the ED.

Correct Answer is A

Explanation

Choice A Reason:
Maintaining the cervical collar in place is crucial for a client with a spinal cord injury at the level of C3-4. This action prevents further damage to the spinal cord by immobilizing the neck and maintaining proper alignment. Any movement could exacerbate the injury, potentially leading to more severe neurological deficits or even paralysis.

Choice B Reason:
Asking the client if they remember any events around the time of the injury is not the priority in this situation. While obtaining a history is important, it should not take precedence over stabilizing the spinal cord to prevent further injury. The primary focus should be on ensuring the client's safety and preventing additional harm.

Choice C Reason:
Explaining to the client that they will never be able to walk again is inappropriate and premature. The prognosis for spinal cord injuries can vary widely, and it is essential to provide accurate information based on a thorough assessment and consultation with specialists. Additionally, delivering such news requires sensitivity and should be done in a supportive manner.

Choice D Reason:
Notifying the client's parents that they are in the ED is important for family communication and support. However, it is not the immediate priority. The primary focus should be on stabilizing the client's condition and preventing further injury. Once the client is stabilized, the nurse can then inform the family.

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Which of the following are risk factors for disseminated intravascular coagulation (DIC)? (Select All that Apply.)

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Naxlex Comprehensive Predictor Exams

Administer heparin 1000 units per hour IV. The pharmacy supplies the heparin infusion as 25,000 units in 500 mL D5W. What will the IV pump be set to? Please include the unit of measures.

Correct Answer is ["20"]

Explanation

Correct Answer is A

Explanation

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