4 Disseminated Intravascular Coagulation Nursing Care Plans

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Disseminated intravascular coagulation (DIC) is a coagulation disorder that prompts overstimulation of the normal clotting cascade and results in simultaneous thrombosis and hemorrhage. The formation of microclots affects tissue perfusion in the major organs, causing hypoxia, ischemia, and tissue damage. Coagulation occurs in two different pathways: intrinsic and extrinsic. These pathways are responsible for the formation of fibrin clots and blood clotting, which maintains homeostasis. In the intrinsic pathway, endothelial cell damage commonly occurs because of sepsis or infection. The extrinsic pathway is initiated by tissue injury such as from malignancy, trauma, or obstetrical complications. DIC may present as an acute or chronic condition.

An essential medical management of DIC is primarily aimed at treating the underlying cause, managing complications from both primary and secondary cause, supporting organ function, and stopping abnormal coagulation and controlling bleeding. Morbidity and mortality depend on underlying cause and severity of coagulopathy.

Nursing Care Plans

The following are the common nursing care planning and goals for clients with DIC: maintenance of hemodynamic status, maintenance of intact skin and oral mucosa, maintenance of fluid balance, maintenance of tissue perfusion, prevention of complications.

Here are four (4) nursing care plans (NCP) and nursing diagnosis for patients with disseminated intravascular coagulation:

  1. Impaired Gas Exchange
  2. Ineffective Tissue Perfusion
  3. Deficient Knowledge
  4. Risk for Bleeding
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Deficient Knowledge

Nursing Diagnosis

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May be related to

  • Complexity of treatment
  • Emotional state affecting learning
  • New condition and/or treatment
  • Unfamiliar environment

Possibly evidenced by

  • Questioning health care team
  • Verbalizing inaccurate information

Desired Outcomes

  • Client and/or significant others verbalize basic understanding of disease condition, risk factors, and treatment regimen.
Nursing Interventions Rationale
Assess the client’s knowledge of DIC. DIC usually occurs acutely, so the client and family have no prior knowledge of it. An assessment provides a baseline for teaching.
Carefully explain the underlying cause that precipitated DIC. Clients are better able to ask questions when they have basic information about what to expect.
Explain the purpose of drug and transfusion therapy. The controversial nature of treatment may be difficult for the client or significant others to understand in the acute setting. In addition, the frequent use of blood components may cause fear regarding the transmission of infectious diseases such as hepatitis or human immunodeficiency virus (HIV).
Instruct the client or significant others to notify the nurse of new bleeding from wounds or IV sites. This notification can aid in achieving early intervention at bleeding sites. However, any new episodes of bleeding may have a traumatic impact on the client and family.
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See Also

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