The nurse should suspect Disseminated Intravascular Coagulation (DIC) if prolonged bleeding and clotting times are observed (option D).
DIC is a serious condition characterized by the widespread activation of clotting factors, leading to the formation of blood clots throughout the body. As a result, the body's clotting factors become depleted, leading to prolonged bleeding times.
In DIC, the clotting process is both accelerated and impaired, resulting in a paradoxical situation where both bleeding and clotting occur. The body's natural anticoagulant systems become overwhelmed, leading to increased clot formation, which can block blood vessels and impair blood flow. However, as the clotting factors become depleted, the ability to form stable clots and control bleeding is diminished, leading to prolonged bleeding times.
The other options are not indicative of DIC:
A. Increased platelet count: DIC is often associated with a decrease in platelet count due to the consumption of platelets during the clotting process.
B. Decreased bleeding: DIC is associated with increased bleeding tendencies rather than decreased bleeding.
C. Elevated blood pressure: While complications of DIC may lead to changes in blood pressure, it is not a direct sign of DIC itself.
In summary, prolonged bleeding and clotting times are signs that the nurse should suspect DIC in a client with abruption placenta. It is essential for the nurse to recognize these signs and provide appropriate interventions to manage and treat DIC promptly.