Included In This Lesson
Outline
Nursing Points
General
- Hematology
- Disseminated intravascular coagulation (DIC)
- Clotting cascade
- Intrinsic -> Injury of endothelium in vessels
- Extrinsic -> Injury of tissue/muscle
- Prothrombin -> thrombin
- Fibrinogen (level is low) -> fibrin (split product level high)
- Plasmin -> clot -> FSP
- PT & PTT high
- Treatment
- Heparin (EXCEPT in OB emergencies)
- Halts the intrinsic pathway
- Prevents thrombin
- Prevents fibrin
- Stops current thrombin
- FFP
- Treat cause
- Heparin (EXCEPT in OB emergencies)
- Clotting cascade
- Heparin-induced thrombocytopenia
- Person doesn’t have anti-thrombin 3 (opposite effect occurs due to issues in metabolism)
- Blood clots
- Treatment -> Argatrobon (ACOVA)
- Anti-thrombin 3 isn’t needed to work
- Idiopathic (Immune) Thrombocytopenic Purpura
- Low platelets from destruction by antibodies
- Causes
- Bone marrow issue
- Platelets stuck in spleen
- Something causing platelet breakdown
- HIV
- Medications
- Heparin
- Quinidine
- Oral diabetic drugs
- DIC
- Septicemia
- Symptoms
- < 50,000 platelets
- Fibrin split product 0
- Low hemoglobin and hematocrit
- Pallor
- Bleeding
- Skin changes
- Petechiae
- Purpura
- Bruising
- Disseminated intravascular coagulation (DIC)
