Monday, April 9, 2012


·         A grave blood coagulation disorder occurs as a complication of conditions that accelerate clotting wherein activation of thrombin & fibrinolytic system results in simultaneous bleeding & thrombosis.
·         Caused by infections, obstetric complications, neoplastic disease, tissue necrosis, cardiac arrest, stroke, incompatible blood transfusion, etc.

Signs & Symptoms:

ü  Petechiae
ü  Ecchymosis
ü  Dyspnea
ü  Prolonged bleeding after venipuncture
ü  Joint pain
ü  Hemorrhage
ü  Purpura
ü  Oliguria
ü  Anxiety
ü  Restlessness

Screening & Diagnosis:

·         Hematology -  ↓platelets, RBC, fibrinogen, factor assay (II,V,VII), ↑fibrin split products, thrombin, PT, PTT, (+) protamine sulfate test 
·         ABG analysis – metabolic acidosis
·         D-dimer test – result (+) ; specific test for DIC


·         Medications
o    Anticoagulants: heparin, antithrombin III (ATnativ®, Thrombate® III)
·         Blood transfusion – platelets, PRBC, FFP, whole blood, volume expanders, cryoprecipitates.
·         Bed rest
·         Oxygen therapy
·         IV therapy : hydration, electrolyte replacement, heparin lock
·         Hemodialysis


·         Acute renal failure
·         Shock
·         CVA
·         Convulsions
·         Hemorrhage
·         Coma

Nursing Interventions:

·         Administer prescribed medications & IV fluids.
·         Monitor cardiovascular, respiratory, & fluid balance.
·         Avoid intramuscular injections, enemas, rectal temperatures & straight razors.
·         Check all IV & venipuncture sites frequently for bleeding.
·         Enforce complete bed rest during bleeding episodes.
·         Monitor for transfusion reactions.
·         Monitor results of blood studies & report any signs of complications.
·         Maintain seizure precautions.

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