A septic patient begins to ooze blood from around intravenous cannulation sites and from the gums. The patient’s urine has turned from concentrated yellow to brown. Upon further assessment, the nurse notes the patient’s right calf is swollen, red, and painful. The nurse anticipates which laboratory abnormalities in this patient? Select all that apply.

Question

A septic patient begins to ooze blood from around intravenous cannulation sites and from the gums. The patient&rsquo;s urine has turned from concentrated yellow to brown. Upon further assessment, the nurse notes the patient&rsquo;s right calf is swollen, red, and painful. The nurse anticipates which laboratory abnormalities in this patient? Select all that apply.

Accepted Answer

Leukocytosis, Thrombocytopenia, Elevated D-dimer level. This septic patient is at risk for developing disseminated intravascular coagulation (DIC), which presents with evidence of simultaneous bleeding (oozing from gums and cannulation sites as well as blood in urine) and thrombosis (deep venous thrombosis &ndash; swollen, red, and painful calf). The workup for DIC includes clotting times (typically prolonged, not shortened), platelet count (thrombocytopenia), and D-dimer levels (which are elevated), among others. Due to the patient&rsquo;s septicemia, the patient likely has a leukocytosis. The patient&rsquo;s red blood cell count is likely still normal due to the patient merely oozing rather than hemorrhaging.

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