BSN 445 Week 13 Sherpath 2026/2027 – 45+ Questions & Answers | DIC, ITP, HIT, Sickle Cell & Tumor Lysis Syndrome

This BSN 445 Week 13 Sherpath 2026/2027 exam preparation resource contains 45+ questions with correct answers across 18 pages, providing focused review of hematologic and oncologic emergencies, coagulation, disseminated intravascular coagulation (DIC), immune thrombocytopenic purpura (ITP), heparin-induced thrombocytopenia (HIT), sickle cell disease, tumor lysis syndrome (TLS), anemia, and blood transfusion. The opening material reviews normal hemostasis and clotting mechanisms, including serotonin-mediated vasoconstriction, thrombin regulation, antithrombin III, platelets, fibrinogen, and coagulation factors, before applying these concepts to critical hematologic disorders. A major section concentrates on disseminated intravascular coagulation (DIC). Students review major precipitating conditions such as sepsis and pregnancy-related complications and examine the pathophysiology of widespread coagulation activation, microvascular thrombus formation, platelet and coagulation-factor consumption, ischemic tissue injury, and simultaneous bleeding risk. Laboratory interpretation includes prothrombin time, fibrinogen, fibrin degradation products, and other coagulation findings. Clinical scenarios emphasize altered mental status, bleeding, tissue ischemia, hemiplegia, hypoxia, and hypotension while also addressing platelet replacement, antithrombin therapy, selected uses of heparin, and supportive treatment. The DIC questions also emphasize potentially fatal complications including hypovolemic shock, acute renal failure, and multiple organ dysfunction syndrome (MODS). This requires students to recognize DIC not simply as a laboratory abnormality but as a systemic emergency capable of simultaneously producing hemorrhage, thrombosis, impaired organ perfusion, and progressive multiorgan injury. Another substantial section examines immune thrombocytopenic purpura (ITP) and heparin-induced thrombocytopenia (HIT). ITP questions address gingival bleeding, pregnancy, chemotherapy, alcohol use, critically low platelet counts, bleeding precautions, corticosteroids, intravenous immunoglobulin (IVIG), and platelet replacement. HIT is differentiated through a significant platelet-count reduction and, importantly, its association with thrombosis rather than bleeding alone. Students review risk factors such as previous cardiac surgery, recognition of limb ischemia and neurologic compromise, patient education about clotting manifestations, and anticoagulation with argatroban. The sickle cell disease and sickle cell crisis section addresses infection as a precipitating factor, hemolysis-related laboratory findings, reticulocytosis, Howell-Jolly bodies, visual complications, temperature stability, nutritional considerations, hydroxyurea dosing, and indications for red-blood-cell transfusion. Serious complications covered include acute chest syndrome, ischemic stroke, and priapism. These questions help students connect sickling and vaso-occlusion with impaired tissue perfusion, hemolysis, acute pain, neurologic injury, pulmonary complications, and the need for rapid intervention. The final major topic is tumor lysis syndrome (TLS), an important oncologic emergency that can develop following anticancer treatment. Students review hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia, weight changes, ECG abnormalities such as widened QRS complexes and peaked T waves, ventricular ectopy, dietary considerations, and pharmacologic management. Treatments discussed include calcium gluconate, insulin with glucose, allopurinol, sodium polystyrene sulfonate, and phosphorus-binding therapies. The questions therefore require students to integrate cancer treatment with renal function, electrolyte disturbances, cardiac monitoring, and emergency intervention. The closing questions address hospital-acquired anemia and packed red blood cell transfusion. Critically ill patients with gastrointestinal bleeding are identified as being at substantial risk for anemia, and severe reductions in hemoglobin are connected with the potential need for transfusion. The material also considers administration of furosemide before packed red blood cells in selected patients with cardiac failure, reinforcing the importance of assessing fluid-overload risk during transfusion therapy. For evidence-based reinforcement, these topics correspond broadly with hematology and critical-care content in AACN Essentials of Critical Care Nursing and Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. DIC, ITP, HIT, sickle cell disease, transfusion therapy, and tumor lysis syndrome should additionally be cross-checked against current guidance from organizations such as the American Society of Hematology (ASH) and contemporary hematology/oncology literature. Current evidence-based guidance is particularly important for anticoagulation, transfusion thresholds, HIT treatment, sickle cell transfusion, and TLS electrolyte management because specific recommendations may change and some answers in educational question banks can be simplified. Relevant Students: This document is particularly relevant for BSN 445 students, Sherpath nursing students, BSN and RN students, critical-care and ICU nursing students, medical-surgical nursing students, hematology and oncology nursing learners, and students preparing for examinations on coagulation and hematologic emergencies. It can also support ATI Adult Medical-Surgical, HESI, NCLEX-RN, and critical-care preparation involving DIC, thrombocytopenia, HIT, sickle cell crisis, tumor lysis syndrome, anemia, blood transfusion, coagulation studies, and emergency nursing interventions. 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