C – Section Case Study – What is the physiology behind DIC after an enormous amount of blood products – Solution

What is the physiology behind DIC after an enormous amount of blood products

A new patient has been brought to the intensive care from the C-section suite. The baby is healthy with normal APGAR scores. During closing, the surgeon noted a hemorrhage occurring in the abdomen. After the prolonged procedure to repair the artery was concluded, the patient had received 15 units of packed red blood cells, 10 units of fresh frozen plasma, and 5 units of platelets. The patient is in the ICU at risk for disseminated intravascular coagulopathy (DIC).

• What is the physiology behind DIC after an enormous amount of blood products?
• Discuss specific assessment findings you are looking for and the diagnostic workup you need to monitor.
• Explain findings that will prompt you to begin treatment for DIC and outline appropriate treatment for DIC.
• What are the risk factors you need to take into consideration when developing a treatment plan for this patient?

Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

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Assessment 2

You are part of a surgical team and your role is postoperative management of thoracic surgery. In your role, you are required to determine the course of action for the patient before you call the surgeon. A right lower-lobe resection occurred due to adenocarcinoma. The nurse has called at the 12-hour interval from surgery concerned with the amount of drainage within the chest tube. Respond to the following and support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

• Describe the role of an AGACNP at each of the steps in postoperative care for a surgical patient.
• Describe the assessment steps you would take.
• Explain the drainage and decompression devices and how you manage these as an AGACNP.
• Discuss potential differential diagnoses you could expect from the assessment.
• Discuss the hemodynamic findings one might see with your provided diagnosis.
• Propose potential treatment plans that would be appropriate.

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Related FAQs

1. What happens physiologically in DIC?

Disseminated intravascular coagulation (DIC) is an acquired clinicobiological syndrome characterized by widespread activation of coagulation leading to fibrin deposition in the vasculature, organ dysfunction, consumption of clotting factors and platelets, and life-threatening hemorrhage.

2. What mechanism caused the DIC?

Acute DIC develops when sudden exposure of blood to procoagulants (eg, tissue factor [TF], or tissue thromboplastin) generates intravascular coagulation. Compensatory hemostatic mechanisms are quickly overwhelmed, and, as a consequence, a severe consumptive coagulopathy leading to hemorrhage develops.

3. What is the mechanism in DIC that causes patients to experience bleeding?

DIC occurs because of aberrant activation of the clotting cascade, leading to fibrin deposition in small vessels, combined with activation of fibrinolytic mechanisms, leading to bleeding.

4. How does DIC affect coagulation?

Disseminated intravascular coagulation (DIC) is a reflection of an underlying systemic disorder which affects the coagulation system, simultaneously resulting in pro-coagulant activation, fibrinolytic activation, and consumption coagulopathy and finally may result in organ dysfunction and death.

5. Does DIC cause bleeding or clotting?

Disseminated intravascular coagulation (DIC) is a rare and serious condition that disrupts your blood flow. It is a blood clotting disorder that can turn into uncontrollable bleeding. DIC can affect people who have cancer or sepsis.

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