A nurse is reviewing the PT, aPTT, and INR laboratory values for a client who is experiencing an acute episode of disseminated intravascular coagulation (DIC). Which of the following laboratory results should the nurse expect?
A.
The laboratory values are within the expected reference range.
B.
The laboratory values are prolonged.
C.
The laboratory values are the same as the previous test values.
D.
The laboratory values are decreased.
The correct answer and Explanation is :
In the context of disseminated intravascular coagulation (DIC), the correct answer is:
B. The laboratory values are prolonged.
Explanation:
Disseminated intravascular coagulation (DIC) is a complex and serious condition characterized by widespread activation of the clotting cascade, leading to the formation of small blood clots throughout the small vessels in the body. This process consumes clotting factors and platelets, which eventually results in bleeding due to the depletion of these critical components.
When evaluating laboratory values for a client experiencing DIC, the nurse would expect the following changes:
- Prothrombin Time (PT): PT measures the time it takes for blood to clot. In DIC, the PT is usually prolonged because the coagulation factors involved in the extrinsic and common pathways are consumed faster than they can be produced.
- Activated Partial Thromboplastin Time (aPTT): aPTT assesses the integrity of the intrinsic and common coagulation pathways. Like PT, aPTT is prolonged in DIC due to the consumption of factors involved in these pathways, particularly factors VIII and IX.
- International Normalized Ratio (INR): INR is a standardized measure of PT. Since PT is prolonged in DIC, INR will also be prolonged. The INR reflects the balance of clotting factors, and its increase indicates a compromised coagulation system.
In summary, during an acute episode of DIC, all these coagulation tests (PT, aPTT, and INR) are typically prolonged. This prolongation reflects the consumption and depletion of clotting factors and platelets, which disrupts normal clotting function and increases bleeding risk. Thus, the nurse should anticipate and monitor for these prolonged laboratory values in clients with DIC.