A patient with possible disseminated intravascular coagulation ...

[NClaborn]

A patient with possible disseminated intravascular coagulation arrives in the emergency department with a blood pressure of 82/40, temperature 102 F (38.9 C), and severe back pain. Which physician order will the nurse implement first?
 
  a. Administer morphine sulfate 4 mg IV.
  b. Give acetaminophen (Tylenol) 650 mg.
  c. Infuse normal saline 500 mL over 30 minutes.
  d. Schedule complete blood count and coagulation studies.

Question 2

A patient with septicemia develops prolonged bleeding from venipuncture sites and blood in the stools. Which action is most important for the nurse to take?
 
  a. Avoid venipunctures.
  b. Notify the patient's physician.
  c. Apply sterile dressings to the sites.
  d. Give prescribed proton-pump inhibitors.

[Danny Ewald]

Answer to Question 1

ANS: C
The patient's blood pressure indicates hypovolemia caused by blood loss and should be addressed immediately to improve perfusion to vital organs. The other actions also are appropriate and should be rapidly implemented, but improving perfusion is the priority for this patient.

Answer to Question 2

ANS: B
The patient's new onset of bleeding and diagnosis of sepsis suggest that disseminated intravascular coagulation (DIC) may have developed, which will require collaborative actions such as diagnostic testing, blood product administration, and heparin administration. The other actions also are appropriate, but the most important action should be to notify the physician so that DIC treatment can be initiated rapidly.

[NClaborn]

Excellent

[mcarey591]

TYSM