Bleeding and coagulation in the PACU.

Abstract

Understanding normal coagulation processes will allow the critical care nurse to also understand disorders of coagulation. Understanding diagnostic tests used to assess coagulation will also allow the critical care nurse to evaluate disorders of coagulation and to identify patients at risk for bleeding disorders. Both should encourage the critical care nurse to institute appropriate measures designed to minimize and detect further bleeding. Nursing interventions will include maintenance of aseptic technique; minimizing tissue trauma (avoid venipunctures, use of a soft toothbrush); guaiacing stools; monitoring oxygenation and level of consciousness; and monitoring laboratory tests, including hemoglobin and hematocrit, along with laboratory tests of coagulation. Prompt detection and intervention will help minimize the morbidity and mortality associated with bleeding and alterations in coagulation.