The development of acute disseminated intravascular coagulation (DIC) is a critical setback for the patient. The nurse knows that which are common risk factors for the development of acute DIC? Select all that apply.

A. Intestinal obstruction: Intestinal obstruction alone does not typically trigger the systemic activation of the coagulation cascade required to produce DIC. While severe complications such as bowel ischemia or perforation could potentially lead to sepsis and secondary DIC, uncomplicated obstruction is not considered a common primary risk factor. B. Abruptio placenta: Abruptio placenta is a well-known obstetric cause of acute DIC. The release of large amounts of tissue factor (thromboplastin) from the damaged placenta into maternal circulation activates the extrinsic coagulation pathway, leading to widespread clot formation and subsequent consumption of clotting factors and platelets. C. Any type of shock: Not all forms of shock independently cause DIC. While septic shock and prolonged hypoperfusion can contribute to coagulopathy, shock itself is not universally associated with DIC unless accompanied by systemic inflammatory or tissue factor–releasing processes. D. Severe trauma and burns: Extensive tissue injury from trauma or major burns releases tissue factor into the circulation, activating widespread coagulation. Massive endothelial damage and systemic inflammatory response further amplify clotting cascade activation, predisposing the patient to consumptive coagulopathy and DIC. E. Sepsis: Sepsis is one of the most common causes of acute DIC. Endotoxins and inflammatory cytokines stimulate systemic coagulation activation and impair natural anticoagulant pathways. This imbalance results in microvascular thrombosis followed by depletion of clotting factors and platelets, leading to bleeding complications.