CHAPTER 4 Hematologic System^185
B 12 to combat the deficiency. The injections eventually become monthly for lifelong
maintenance. Oral supplementation is not effective in these patients because they
cannot adequately absorb vitamin B 12 due to insufficient intrinsic factor.
- Administer vitamin B 12 by IM injection.
- Transfusion of packed RBC if anemia is severe.
NURSING DIAGNOSES
- Impaired gas exchange
- Imbalanced nutrition, less than what body requires
- Risk for injury
NURSING INTERVENTION
- Prevent injuries.
- Explain to the patient:
- Use soft toothbrush due to oral changes.
- Avoid activities that could lead to injury due to paresthesias or changes in
balance. - Inspect feet each day for injury due to paresthesia.
Disseminated Intravascular Coagulation (DIC)
WHAT WENT WRONG?
Blood coagulates through the entire body within the vascular compartment. This
depletes platelets and the body’s ability to coagulate, resulting in an increased risk
of hemorrhage. It occurs as a complication of some other condition. The coagula-
tion sequence is activated causing many microthrombi to develop throughout the
body. The clots that form are the result of coagulation proteins and platelets, result-
ing in the risk of bleeding or severe hemorrhage. It is often due to obstetric com-
plications, posttrauma, sepsis, cancer, or shock.
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