The nurse is planning an in-service educational program to talk about disseminating intravascular coagulation (DIC). The nurse should identify which of the following as risk factors for developing DIC? Select all that apply
1. Diabetes mellitus
2. Abruptio placentae
3. Prolonged retention of a fetus after demise
4. Multiparity
5. Preterm labor
2, 3
Rationale:
1. Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
2. Abruptio placentae leave intrauterine arteries open and bleeding. This results in release of thromboplastin into the maternal blood supply, and triggers the development of DIC. In prolonged retention of the fetus after demise, thromboplastin is released from the degenerating fetal tissues into the maternal bloodstream, which activates the extrinsic clotting system. This triggers the formation of multiple tiny clots, which deplete the fibrinogen and factors V and VII, and result in DIC.
3. Abruptio placentae leave intrauterine arteries open and bleeding. This results in release of thromboplastin into the maternal blood supply, and triggers the development of DIC. In prolonged retention of the fetus after demise, thromboplastin is released from the degenerating fetal tissues into the maternal bloodstream, which activates the extrinsic clotting system. This triggers the formation of multiple tiny clots, which deplete the fibrinogen and factors V and VII, and result in DIC.
4. Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
5. Diabetes, multiparity, and preterm labor do not cause the same release of thromboplastin that triggers DIC.
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