COAGULATIONS disorders (1).pptx for coagulation

COAGULATIONS disorders (1).pptx for coagulation

1. COAGULATION DISORDERS

2. Coagulation disorders include: Disseminated intravascular coagulation (DIC). Haemophilia. Thrombocytopenia.

3. Disseminated intravascular coagulation (DIC) DIC is not a disease in it’s self but a syndrome that occurs because of a primary disease process or condition A few of the conditions in which DIC may occur are: Burns, acute leukaemia, metastatic cancer, polycythemia Vera, pheochromocytomia, shock, acute infections, septic abortion, abruption placenta, blood transfusion reaction & trauma .

4. i. DIC is condition of alternating clotting and haemorrhaging ii. The primary disease stimulates the clotting mechanism, causing many microthrombi (very small clots) to form and block the circulation in the arterioles the capillaries iii. Formation of the numerous small clots, the body’s fibrinolytic process responds iv

5. In an attempt to stop a clot information, thus causing hemorrhage This can be very serous and potentially fatal condition The occlusion of blood vessels with clots causes infarcts, necrosis of organs and tissues The kidneys are the most organs affected

6. Clinical features i. Purpura (reddish purple patches on the skin indicative of haemorrhage) ii. Bleeding tendencies oozing from venipunctive, mucus membrane or surgical wound oozing may progress rapidly into a haemorrhage within a few hours to a day iii. The client may have decreased urine output from decreased blood flow or renal infraction

7. Patho physiology of DIC Primary disease. Stimulation of clotting mechanism. Micro thrombi formation process Fibrinolysis Depletion of clotting factors obstruction of circulation tendency Bleeding organ and tissue Necrosis Haemorrhage

8. Management DIC is diagnosed by the client symptoms and laboratory tests With DIC there is an increased prothrombin time, partial thromboplastin time, thrombin time and decreased fibrinogen & platelet count. Laboratory test that confirms the diagnosis is the D dimer which measures fibrin split product that is released when a clot breaks

9. The primary disease or condition must be treated eg if the primary disease is an infection, an antibiotic is given .If it’s cancer, chemotherapy is given . DIC is treated by administering whole blood or platelets or packed red cells are given to replace those lost during hemorrhage. Cryprecipitate or fresh frozen plasma is given to normalize clotting factor levels.

10. Pharmacological management Heparin has no effect on thrombi that are already formed but may be given to prevent formation of more micro thrombi The administration of heparin is controversial because of the risk of hemorrhage .After thrombi formation has been controlled with heparin , aminocaproic acid ( amicar ) can be given to stop the bleeding because it stops the fibrinolytic process Fibrinolysis is the process of breaking fibrin apart.

11. NURSING CONCERNS Bleeding /Hemorrhage Risk of injury related to altering clotting factors. Risk for body fluid volume deficit Anxiety