Abstract
Disseminated intravascular coagulation, also referred to as “consumption coagulopathy” or “DIC,” is an abnormality in the body’s normal blood clotting process. During this condition, excessive clotting occurs throughout the small blood vessels of the body. This widespread clotting depletes existing clotting factors and platelets leaving the body unable to form a clot at the site of a real tissue injury. As a result, extensive bleeding occurs. Bleeding from multiple sites is the most common complication. Bleeding may vary from scant to fatal hemorrhage. Disseminated intravascular coagulation often occurs in conjunction with many severe illnesses, including: cancer, liver disease, recent sepsis, trauma, surgery, anesthesia, transfusion…show more content… Prompt identification of this disorder may be the difference between life and death. According to Uribe (2016), “the first sign of DIC can be oozing or explicit bleeding. Other signs and symptoms include bleeding from multiple sites (e.g., nose, gums, vagina, venipuncture sites, wounds); sudden onset of bruising; thrombosis; hematemesis; jaundice; severe muscle, back, and/or chest pain; tachycardia; hypotension; oliguria; shortness of breath; cough; confusion; and disorientation.” Therefore, assess for and report any deviation in the client’s baseline status. It is important to monitor the clients skin and mucous membranes for any abnormal bleeding, ecchymosis, or petechiae. Bleeding can occur from any orifice, venipuncture site, or intramuscular injection site. Monitor the clients stool, urine, and emesis for occult…show more content… Implementation
Management of disseminated intravascular coagulation includes treating any identifiable
underlying causes first. These may include implementing supportive measure such as:
ensuring adequate oxygenation, correcting fluid and electrolyte imbalances, or administering
vassopressors. After assessing these possible causes, management then involves the replacement
of the depleted clotting factors, platelets, or fibrinogen. Replacement is achieved through the
administration of fresh frozen plasma, cryoprecipitate, or platelets. Heparin, although
controversial, may be given to treat uncontrolled thrombosis. Heparin is used to inhibit
coagulation and may only be used in clients who continue in disseminated intravascular
coagulation after blood replacement has failed. Activated protein C may also be given to prevent
inappropriate clot formation and has been shown to reduce mortality rates.
Evaluation
When treating a client with disseminated intravascular coagulation the nurse observes
