In managing a patient with disseminated intravascular coagulation (DIC), which of the following interventions should the nurse anticipate? Select all that apply.

Rationale: A. This is the most critical and first-line priority in managing DIC. DIC is not a primary disease but a complication of conditions such as sepsis, trauma, malignancy, or obstetric emergencies (e.g., placental abruption). The widespread activation of the clotting cascade will continue unless the trigger is removed. For example, administering antibiotics for sepsis or delivering the placenta in obstetric cases directly addresses the root cause. Without this step, supportive treatments alone will be ineffective. B. Beta blockers are used to manage conditions such as hypertension, arrhythmias, or heart failure. They have no role in correcting the coagulation abnormalities seen in DIC. They do not affect platelet consumption, clotting factor depletion, or fibrinolysis. Therefore, this option is inappropriate and incorrect. C. Although it may seem counterintuitive in a condition associated with bleeding, heparin can be used in selected cases of DIC, particularly when thrombotic manifestations predominate (e.g., digital ischemia, organ dysfunction from microthrombi, or chronic DIC). Heparin works by inhibiting further clot formation, thereby reducing consumption of clotting factors and platelets. However, it is used cautiously and is generally avoided in patients with severe active bleeding. This makes it a situational but appropriate intervention. D. Patients with DIC are at high risk for hypovolemia and shock due to bleeding and capillary leakage. Isotonic fluids like lactated Ringer’s help maintain intravascular volume, blood pressure, and organ perfusion. Adequate fluid resuscitation is essential to prevent complications such as acute kidney injury and multi-organ failure. This is a key supportive therapy. E. In DIC, clotting factors are rapidly consumed, leading to coagulopathy and bleeding. FFP contains all clotting factors and is administered to replace depleted factors, correct prolonged PT/INR and aPTT, and help control bleeding. It is especially indicated in patients with active bleeding or those at high risk for bleeding.