NURS 6501: Final Exam:
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A nurse practitioner is evaluating a patient with suspected disseminated intravascular coagulation (DIC). Which of the following clinical presentations is most consistent with DIC?
Group of answer choices
- Spontaneous bruising and bleeding, including oozing from venipuncture sites
- Isolated deep vein thrombosis with no bleeding
- Excessive clotting without any bleeding manifestations
- Prolonged bleeding following surgical procedures only
The correct answer is:
Spontaneous bruising and bleeding, including oozing from venipuncture sites
Explanation:
Disseminated Intravascular Coagulation (DIC) is a complex, systemic condition characterized by widespread clotting and bleeding. In DIC, there is widespread activation of the coagulation system, leading to the formation of microthrombi (small blood clots) in the blood vessels throughout the body. This leads to consumption of clotting factors and platelets, resulting in a bleeding tendency.
The clinical presentation most consistent with DIC includes:
Spontaneous bruising and bleeding: This can manifest as petechiae, purpura, and oozing from venipuncture sites, as the body runs out of clotting factors and platelets due to widespread clotting.
Signs of both clotting and bleeding: This is a hallmark feature of DIC. Patients may present with clotting in some areas and bleeding in others.
Other options are less consistent with DIC:
Isolated deep vein thrombosis (DVT) with no bleeding: While DVT can be seen in some coagulopathies, DIC typically involves both clotting and bleeding, not just clotting in isolation.
Excessive clotting without any bleeding manifestations: This is not characteristic of DIC; the hallmark of DIC is both clotting and bleeding.
Prolonged bleeding following surgical procedures only: This could indicate a bleeding disorder but does not capture the widespread nature of DIC, where bleeding can occur spontaneously, not just after surgery.
