A 70-year-old patient with septic shock develops bleeding from IV sites, petechiae, hypotension (BP 80/44), and decreasing urine output. Labs: platelets 30,000/µl, prolonged PT and aPTT, low fibrinogen, elevated D-dimer. What is the priority nursing intervention?

The clinical picture described — bleeding from IV sites, petechiae, hypotension, decreasing urine output, thrombocytopenia (platelets 30,000/µl), prolonged PT and aPTT, low fibrinogen, and elevated D-dimer in a patient with septic shock — is classic for disseminated intravascular coagulation (DIC). DIC is a consumptive coagulopathy in which widespread activation of the coagulation cascade leads to simultaneous thrombosis and hemorrhage, depleting clotting factors and platelets. The priority nursing intervention is preparing for and administering replacement blood products: platelets to restore platelet counts and cryoprecipitate to replace fibrinogen and clotting factors. This directly addresses the life-threatening hemorrhagic component. Vitamin K is used for warfarin reversal or vitamin K deficiency and does not address the consumptive coagulopathy of DIC. Warm compresses are inappropriate and could worsen bleeding. Encouraging ambulation is contraindicated in a hemodynamically unstable, actively bleeding patient. In DIC management, treating the underlying cause (sepsis) alongside replacing consumed blood components is the dual-priority approach, and the immediate nursing action is coordinating product preparation and administration.