Question

If a nurse observes these signs and symptoms in a patient, which complication of shock is the patient experiencing?

Decreased platelets
Decreased fibrinogen
Elevated D-dimer
Ischemia of fingers and toes

A. Acute respiratory distress syndrome (ARDS)
B. Acute renal failure (ARF)
C. Disseminated intravascular coagulation (DIC)
D. Multiple organ dysfunction syndrome (MODS)

Answer 1

The patient with decreased platelets, decreased fibrinogen, elevated D-dimer, and ischemia of fingers and toes is most likely experiencing Disseminated Intravascular Coagulation (DIC), a complication of shock.

Step-by-step explanation:

The signs and symptoms described in the question – decreased platelets, decreased fibrinogen, elevated D-dimer, and ischemia of fingers and toes – are suggestive of Disseminated Intravascular Coagulation (DIC). DIC is a serious complication that can arise from shock, particularly septic shock, and involves widespread activation of clotting in the small blood vessels throughout the body. This leads to the formation of clots and subsequent consumption of clotting factors and platelets, which then causes bleeding due to the depletion of these factors.

The elevated D-dimer is a byproduct of clot breakdown and is usually high in DIC. The ischemia in fingers and toes is due to the microscopic clots obstructing the flow of blood to the extremities.