In caring for the woman with disseminated intravascular coagulation (DIC), which order should the nurse anticipate?
A.
Administration of steroids
B.
Administration of blood
C.
Restriction of intravascular fluids
D.
Preparation of the client for invasive hemodynamic monitoring
The correct answer and Explanation is :
In caring for a patient with disseminated intravascular coagulation (DIC), the nurse should anticipate the administration of blood (B) as the priority intervention.
Explanation
DIC is a serious condition characterized by the abnormal activation of the coagulation cascade, leading to the formation of blood clots throughout small blood vessels, which can result in organ damage and bleeding due to consumption of platelets and clotting factors. The management of DIC focuses on treating the underlying cause, supporting the patient’s hemostatic function, and addressing any resulting complications.
Administration of blood (B) is crucial because patients with DIC often experience significant thrombocytopenia (low platelet count) and depletion of clotting factors, leading to an increased risk of bleeding. Transfusion of platelets can help restore platelet levels, while the administration of fresh frozen plasma can replenish clotting factors. This immediate intervention addresses the risk of hemorrhage and stabilizes the patient, which is essential given the potentially rapid progression of DIC.
Administration of steroids (A) may be considered in certain cases, particularly if the DIC is associated with an inflammatory process; however, it is not a first-line treatment for DIC itself.
Restriction of intravascular fluids (C) is generally not indicated in DIC management. Instead, careful fluid management may be needed to maintain hemodynamic stability, especially if the patient is experiencing hypotension.
Preparation for invasive hemodynamic monitoring (D) could be necessary for critically ill patients to assess their cardiovascular status and guide treatment. However, this is typically a later step after stabilizing the patient through more immediate interventions like blood products.
In summary, the administration of blood products is the most urgent and effective intervention to address the complications of DIC, making it the correct order to anticipate in the nursing care plan.