A nurse is teaching a client who has septic shock about the development of disseminated intravascular coagulation (DIC). Which of the following statements should the nurse make?
A.
“DIC is controllable with lifelong heparin usage.”
B.
“DIC is caused by abnormal coagulation involving fibrinogen.”
C.
“DIC is a genetic disorder involving a vitamin K deficiency.”
D.
“DIC is characterized by an elevated platelet count.”
The Correct Answer and Explanation is:
The correct answer is:
B. “DIC is caused by abnormal coagulation involving fibrinogen.”
Explanation:
Disseminated Intravascular Coagulation (DIC) is a complex condition that arises from widespread activation of the coagulation pathways, leading to both clot formation and hemorrhage. This abnormal coagulation is often triggered by conditions such as sepsis, trauma, cancer, or severe infections, with septic shock being a leading cause. In DIC, the body’s coagulation system is excessively activated, resulting in the formation of small blood clots in the blood vessels. These clots consume large amounts of clotting factors, including fibrinogen, and platelets, which can eventually lead to bleeding.
Option B is correct because DIC primarily involves an abnormal coagulation process, where fibrinogen (a protein essential for clot formation) is consumed excessively. The widespread clotting depletes fibrinogen and other clotting factors, resulting in a paradoxical situation where the body both clots and bleeds simultaneously. The abnormal clotting leads to organ damage due to the blockage of small blood vessels, while the depletion of clotting factors and platelets leads to bleeding, often manifesting as bleeding from the gums, nose, or even internal organs.
Option A is incorrect because DIC is not typically managed with lifelong heparin usage. Heparin may be used temporarily to prevent excessive clot formation in some cases, but the treatment of DIC focuses on addressing the underlying cause (e.g., infection or trauma) and supporting the body’s clotting mechanisms.
Option C is incorrect because DIC is not a genetic disorder or related to vitamin K deficiency. It is an acquired condition that arises in response to a serious underlying condition, like sepsis or trauma.
Option D is incorrect because DIC is associated with a decreased platelet count due to the consumption of platelets in the formation of clots. Elevated platelet counts are not a feature of DIC.
Overall, educating the patient on DIC emphasizes the critical role of abnormal coagulation involving fibrinogen and the need to address the underlying cause to manage the condition.