Medical-surgical Nursing Demystified

(^186) Medical-Surgical Nursing Demystified
PROGNOSIS
The prognosis varies depending on the underlying disease process and the ability
to reverse the coagulopathy.
HALLMARK SIGNS AND SYMPTOMS

• Unexpected bleeding—oozing from puncture sites (venipuncture, IVs, sur-
  gical wounds)


• Petechiae as clotting factors are lost


• Purpura as clotting factors are lost


• Severe hemorrhage as clotting factors are lost


• Uncontrolled postpartum bleeding


• Tissue hypoxia from microemboli


• Hemolytic anemia, as cells are destroyed trying to pass through partially
  blocked vessels

INTERPRETING TEST RESULTS

• PT prolonged.


• PTT normal or prolonged.


• Platelet count low—thrombocytopenia.


• Fibrin degradation products elevated:
  
  
  • D-dimer may be elevated.
  
  
  
  

TREATMENT

Treatment needs to decrease coagulation ability (to prevent further clot develop-

ment) and replace clotting components (to prevent further bleeding). Other inter-

ventions may be necessary depending on the locations of clot development and

any compromise of body system function due to clot formation.

• Transfusion:
  
  
  • Packed RBC to replace what has been lost due to bleeding.
  
  
  • Fresh frozen plasma—replaces coagulation factor deficiency.