A patient with multiple organ dysfunction syndrome exhibits changes in level of consciousness. Which pathologic change would the nurse expect?
1. WBC of 9,000 mm3
2. PaO2 85
3. blood gas results: pH = 7.34, PaCO2 = 56, HCO3 = 22
4. platelet count of > 50,000/mm3
4
Rationale: The correct answer is platelet count of > 50,000/mm3, indicating a microvascular coagulopathy. Thrombocytopenia occurs in disseminated intravascular coagulation, a complication in late multiple organ dysfunction syndrome. Multiple organ dysfunction syndromes' pathologic changes include uncontrolled systemic inflammation, tissue hypoxia, dysregulated apoptosis, and microvascular coagulopathy. A white blood cell count of 9,000 mm3 and PaO2 85 are incorrect because they are normal laboratory results indicating no inflammation or tissue hypoxia. The blood gas results of pH = 7.34, PaCO2 = 56, HCO3 = 22 is incorrect because the presence of respiratory acidosis demonstrates the patient's ability to exchange air with blood in the lungs and not cellular death.
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