A male client was involved in a motor vehicle accident earlier in the day. The nurse caring for him on evenings notices that on admission to the hospital, he lost a lot of blood and required multiple blood transfusions. The nurse would anticipate which blood product would be ordered when a large blood loss has occurred?

1. A

   Whole blood

2. B

   Platelets

3. C

   Fresh frozen plasma

4. D

   WBC

Appeared in: NORCET 5 mains

Explanation

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• Whole blood is indicated for rapid replacement of both blood volume and oxygen-carrying capacity in cases of massive acute hemorrhage.
• It contains red blood cells, plasma, and clotting factors, making it suitable for situations where both volume and all blood components are lost.
• Whole blood restores blood volume, increases hematocrit, and provides coagulation factors needed in severe hemorrhage.
• Key differentiator: Only whole blood provides a complete replacement of all blood components lost in acute, large-volume hemorrhage.

Why Other Options Were Wrong

• Option B: Platelets are used to treat or prevent bleeding due to low platelet count or platelet dysfunction, not for volume or oxygen-carrying capacity replacement.
• Option C: Fresh frozen plasma is used to replace clotting factors in coagulopathies or when there is a deficiency of specific plasma proteins, not for primary volume or red cell replacement.
• Option D: White blood cell transfusions are extremely rare and reserved for severe, refractory neutropenia with infection; not used for blood loss.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Selection of appropriate blood product for acute, massive blood loss to guide bedside assessment, documentation, and the next nursing action.
• Nurses must recognize when whole blood is needed for rapid resuscitation in trauma or massive hemorrhage.
• Early identification and communication with the blood bank can save lives in acute bleeding scenarios.
• What if? If the patient had only mild anemia without active bleeding, packed red blood cells would be preferred over whole blood.

How to Approach the Question

• Identify the clinical scenario: acute, large-volume blood loss from trauma.
• Recall the contents and indications for each blood product.
• Eliminate options that do not provide both volume and oxygen-carrying capacity.
• Select the product that replaces all lost components in massive hemorrhage.

Concept Tested & Keywords

• Concept Tested: Selection of appropriate blood product for acute, massive blood loss
• Stem keywords: motor vehicle accident, massive blood loss, multiple transfusions, blood product
• Lead-in keywords: anticipate, ordered, large blood loss
• Clinical cues: acute trauma
• Clinical cues: severe hemorrhage

Question ID

qvVQbaXbajg6y818AoHY-

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 806-808

E6 Gynecology Williams p. 9-33