Hemostasis

The body's process of stopping bleeding through clot formation

Definition

Hemostasis is the physiologic process of stopping blood loss through a coordinated sequence: vasoconstriction, platelet plug formation (primary), and coagulation cascade activation (secondary).

Stages

  1. Vascular phase: Vessel constriction.
  2. Primary hemostasis (platelet plug): Platelet adhesion, activation, aggregation.
  3. Secondary hemostasis (coagulation cascade): Fibrin formation stabilizes plug.
  4. Fibrinolysis: Clot breakdown (plasmin) after healing.

Disorders of Hemostasis

  • Bleeding disorders: Thrombocytopenia, hemophilia, von Willebrand disease, DIC, liver disease
  • Clotting disorders: Factor V Leiden, antiphospholipid syndrome, heparin-induced thrombocytopenia (HIT)

Nursing Considerations

Monitor platelets, PT/INR, aPTT, fibrinogen. Implement bleeding precautions for coagulopathy; DVT prophylaxis for hypercoagulability, for DIC, treat underlying cause and support with blood products.

NCLEX Relevance

Understanding hemostasis underpins anticoagulation and bleeding management.