DIC

Question 1

DIC AKA

Answer 1

Disseminated Intravascular Coagulation

Question 2

WHAT IS DIC

Answer 2

Over activation of the clotting cascade and fibrinolytic system causing widespread consumption of clotting factors and platelets. Also known as ‘consumptive coagulopathy’. Always a secondary diagnosis that results in increased and widespread bleeding.

Question 3

DIC CAN BE CONSIDERED

Answer 3

Acute (shock, septicemia, malignancies, tissue damage (extensive burns, severe head injuries, emboli)
Subacute (metastatic cancer, retained fetal demise)
Chronic (liver disease, SLE)

Question 4

causative disease processes fall into 3 categories

Answer 4

Infusion of thromboplastin into the circulation that uses up clotting factors (placental abruption, retained fetal demise)
Endothelial damage from severe pre eclampsia or HELLP syndrome
Non-specific effects from conditions such as sepsis or amniotic fluid embolism in pregnancy

Question 5

DX OF DIC is based on clinical findings and lab markers

Answer 5

Unusual bleeding
Platelets & fibrinogen
Pt/Ptt
Fibrin Split Products (FSP) or presence of Fibrin Degradation Products (FDP)

Question 6

manifest of DIC

Answer 6

Pallor
Petiechiae
Hematuria
GI bleeding
Hemoptysis
Hematomas 
Oozing from venipuncture sites
ARDS
Hypotension
Changes in mental status

Question 7

mgmt of dic (correct underlying cause)

Answer 7

IV fluids
Replace platelets, FFP, cryoprecipitate
Transfuse w/PRBCs

Question 8

nurs implications of DIC

Answer 8

Do not remove crusts from wounds
Do not remove existing IV lines unless absolutely necessary
No IM injections
Use manual B/P cuff
Monitor secretions/output for bleeding
Monitor vitals
Epidural block contraindicated in the presence of abnormal coagulation studies.