Disseminated Intravascular Coagulation in the Neonate.

Disseminated intravascular coagulation (DIC) is a serious secondary disease that alters the events in the clotting cascade. DIC leads to microclots in the peripheral vasculature. The uncontrolled formation of these clots consumes the body's clotting factors, which precipitates bleeding. Neonates, defined as newborns zero to one month old, are born with slightly altered hemostasis, also known as developmental coagulopathy. This coagulopathy puts neonates at a greater risk of developing DIC, specifically when additional body systems have been compromised by a primary disease. Because of the serious nature of this disease and its precipitating factors, advanced practitioners should study the nuances of DIC to provide accurate diagnosis and proper treatment. The aim of this article is to discuss the pathophysiology behind DIC along with etiologies, diagnosis, treatment, and prognosis in neonates, along with gaps in current research.

Impact of an Alert System on Quality Indicators in Patients With Acute Promyelocytic Leukemia.

BACKGROUND: Acute promyelocytic leukemia (APL), once the most lethal form of adult acute leukemia, has become the most curable. The goal of early and well-managed treatment induction is to reduce the malignant burden of promyelocytes to below the cytologically detectable level. OBJECTIVES: Oncology nurses who care for patients with APL need to be acutely aware of the basic differences in this disease from other forms of leukemia, including the two main complications for the newly diagnosed patient. METHODS: This article will briefly review APL and its associated presenting symptoms, prognosis, treatment, and complications. FINDINGS: These complications require immediate activation of expert staff and resources to protect critically ill patients with APL from associated morbidity and mortality.

An obstetric simulation experience in an undergraduate nursing curriculum.

Educators face the dilemma of conveying didactic information in concise, creative ways that evoke critical thinking. In addition, high patient acuity, coupled with a growing nursing shortage, requires assimilation of didactic knowledge into sound clinical judgment in a timely manner. Human simulation offers a creative teaching modality that allows transference of textbook knowledge into a real-life situation where nursing students can function in their role without untoward effects to their clients. The author illustrates the use of a human birthing simulator, Noelle, in an undergraduate nursing program as a creative and effective teaching strategy.

Disseminated intravascular coagulation (DIC).

Disseminated intravascular coagulation (DIC) is a condition that is seen in critical care areas in association with a number of precipitating conditions. DIC is often described as a paradoxical disease process of concurrent haemorrhage and thrombus formation, resulting in a range of clinical manifestations related to end organ ischaemia. This article will discuss the coagulation cascade as a basis for understanding the aetiology and pathophysiology of DIC. The discourse surrounding medical treatment will be highlighted to enable bedside nurses to understand the divergent orders they may receive from physicians for different patients. Management of the patient experiencing DIC will be approached from a multidisciplinary focus, as well as highlighting the specific nursing considerations and alternatives from an independent focus.

Dealing with coagulopathies of pregnancy-induced hypertension.

A woman with pregnancy-induced hypertension may experience a potentially fatal bleeding disorder. This article describes how to recognize trouble and intervene appropriately.

Intraoperative disseminated intravascular coagulopathy.

Perioperative management of DIC is, at best, difficult, but it is not impossible. Preventing the onset of DIC is the key and is best achieved by recognizing and correcting predisposing factors. Nurses caring for critically injured patients must exercise a high index of suspicion and prepare for dealing with these risk factors. The development of a massive transfusion protocol assists in maintaining a proactive approach to managing patients in need of multiple transfusions of blood and blood components. Alternative approaches to surgical management might assist the patient by allowing the health care team to rapidly identify and correct any predisposing factors rather than allowing them to go unchecked, resulting in uncontrolled complications, such as DIC and patient death.

Disseminated intravascular coagulation.

OBJECTIVES: To provide an overview of the pathophysiology, manifestations, diagnosis, and treatment of disseminated intravascular coagulation (DIC) as it occurs in cancer. DATA SOURCES: Published articles, research reports, and book chapters. CONCLUSIONS: The syndrome of DIC is a serious hypercoagulation state that in its acute form may be life-threatening. The hemorrhage and intravascular coagulation that occur with DIC may lead to irreversible morbidity and mortality. Prompt recognition and emergency treatment are necessary to help minimize morbidity and mortality. IMPLICATIONS FOR NURSING PRACTICE: Nurses can play an important role in early recognition of DIC to allow for prompt intervention. Nurses caring for patients affected by DIC will be providing complex nursing care, in addition to psychosocial support to patients and families.

Hematologic emergencies in the intensive care unit.

Hematologic emergencies in the oncology population may require an admission to the intensive care unit (ICU). Syndrome of inappropriate antidiuretic hormone, hypercalcemia, tumor lysis syndrome, and disseminated intravascular coagulation are diseases defined in this article. These are common conditions in oncology patients that are reduced or prevented with close monitoring and accurate assessments. The purpose of this article is to introduce intensive care nurses to these disease entities so they will have a better understanding of the care involved with an oncology patient in the ICU unit.

Disseminated intravascular coagulation.

First hemorrhage, then ischemia threaten your patient in this paradoxical disorder. Here are the essential signs to watch for and steps to take.

Disseminated intravascular coagulation with leukemia patients.

Disseminated intravascular coagulation (DIC) is a perplexing syndrome that involves both clot formation and bleeding. The management of this syndrome for leukemia patients is especially difficult because of the abnormal coagulation parameters already present in this population. The purpose of this article is to describe normal blood coagulation physiology and the pathophysiology of DIC, and identify appropriate nursing diagnoses and interventions for the leukemia patient with DIC.

Disseminated intravascular coagulation. Principles, treatment, nursing management.

Disseminated intravascular coagulation is an abnormal syndrome that occurs secondary to clinical conditions that result in widespread microthrombosis, macrothrombosis, and hemorrhage. Depending on the primary clinical condition and the intensity and duration of the bleeding episode, mortality can be high. Treatment is first directed at the primary clinical condition followed by measures to stabilize coagulation and fibrinolysis and to replenish body fluids, blood, and blood products. Continual assessment of clinical manifestations and evaluation of laboratory values are used to monitor therapy effectiveness.

Disseminated intravascular coagulation.

In normal hemostasis, a balance exists between coagulation and fibrinolysis. Disseminated intravascular coagulation (DIC) is a condition characterized by the excessive formation of fibrin clots; it involves all aspects of the coagulation system. In view of its potential for major morbidity and mortality, an understanding of the disorder is essential. Management of DIC in pregnancy should include removal of the triggering mechanism and aggressive blood and fluid replacement.