exam 2 hemorrhagic disorders

Question 1

what is stillbirth?

Answer 1

gestational age of ≧ 20 weeks

Question 2

what do you need to know about cerclage?

Answer 2

Treatment of choice for cervical insufficiency

Procedure: McDonald technique: stich the cervix to keep the baby in the womb

Follow up care: bed rest, pelvic rest ( no sex), NOTHING in the vagina

Patient education

Question 3

what is DIC?

Answer 3

disseminated intravascular coagulation

Primary diagnosis: pre-eclampsia
always a secondary diagnosis

characterized by clotting, bleeding, & ischemia

Question 4

what are the possible causes of DIC?

Answer 4

possible causes: placental abruption, retained dead fetus syndrome, amniotic fluid embolus, pre-eclampsia HELLP syndrome, gram-negative sepsis

Question 5

what are the CM for DIC?

Answer 5

Signs of Thrombosis
Bleeding from 3 unrelated sites
Spontaneous Epistaxis
Oozing from venipunture sites
Petechiae
Ecchymosis (bruising)
Large subcutaneous hematomas
Hypotension
Tachycardia

Question 6

what is the diagnosis for DIC?

Answer 6

laboratory tests, may see clinical manifestations upon assessment

Question 7

what are the lab results for DIC?

Answer 7

Platelet – decreased
Fibrinogen – decreased
Prothrombin time – prolonged
Activated partial thromboplastin time (APTT) – prolonged
Fibrin degradation Products (fibrin split) – increased
D-dimer test - increased

Question 8

what is the management for DIC?

Answer 8

correct the underlying cause, supportive management, & continue to monitor labs