DIC

dic characteristics

Serious bleeding and clotting disorder

Abnormal clotting → depletes factors and platelets

Triggered by underlying condition (not a disease itself)

DIC RFs: categories

acute

subacute

chronic

DIC RFS by categories

bleeding clinical manifestations: integumentary 5

THINK bleeding/blood loss/thrombocytopenia

Pallor

Petechiae, purpura, oozing blood

Venipuncture site bleeding

Hematomas

Occult hemorrhage

bleeding clinical manifestations

• respiratory and musculoskeletal

respiratory

• tachypnea, hemoptysis, orthopnea

musculoskeletal

• bone/joint pain

cardiovascular/GI

CV: tachycardia, hypotension

GI

• Upper and lower GI bleeding

• Abdominal distention

• Bloody stools

Urinary 1 and Neurologic 5

Urinary: Hematuria

Neurologic

• Vision changes

• Dizziness

• Headache

• Changes in mental status

• Irritability

THROMBOTIC: integumentary

Cyanosis

Ischemic tissue necrosis (e.g., gangrene)

Hemorrhagic necrosis

Bloody stools

respiratory thrmobotic

Tachypnea

Dyspnea

Pulmonary emboli

Acute Respiratory Distress Syndrome (ARDS)

CV, GI, and renal

CV: ECG changes, venous distention

GI: abd pain, paralytic ileus

renal:

• aki, oliguria, renal failure

DIC lab dx

• list

• explained/chat in pic

Prolonged PT

Prolonged PTT

Low Fibrinogen

Low Platelets

Elevated Fibrin

Elevated D Dimer

lab value ranges

DIC mgt: care plan? or order of care?

diagnose dic

stabilize (supplemental o2 or volume replacement)

tx underlying cause

control ongoing thrombosis and bleeding

• Bleeding: provide blood products as needed

• Thrombosis: consider heparin if indicated (PO do not work)

DIC NSN mgt

identify RFs and manifestations of DIC

Administer prescribed therapies without delay

GOALS

• assess for bleeding and microthrmobi

• Minimize tissue damage and prevent additional sources of bleeding

NSN DX 4

Ineffective peripheral tissue perfusion related to bleeding and sluggish or diminished blood flow secondary to thrombosis

Acute pain related to bleeding into tissues and diagnostic procedures

Decreased cardiac output related to fluid volume deficit

Anxiety related to fear of the unknown, disease process, diagnostic procedures, therapy