NORCET 5 Prelims - Se…: A patient is having active bleeding in lower limb. Which is a priority nursing intervention?

NORCET 5 Prelims - Sept 2023 (Shift-2)

Medical & Surgical Nursing

Medium

Appeared in: NORCET 5 Prelims - Sept 2023 (Shift-2)

Explanation

Applying direct, firm pressure over the bleeding site is the most immediate and effective first-line intervention to control external hemorrhage.
This action mechanically obstructs blood flow from the damaged vessel, promoting hemostasis and preventing the patient from progressing into hypovolemic shock.
It is the foundational first step in all emergency bleeding control protocols, such as 'Stop the Bleed', and must be initiated before any other treatment.

Option A: DVT (Deep Vein Thrombosis) sleeves are pneumatic compression devices used to prevent blood clots in the legs of immobile patients. They are not designed for and have no role in controlling active bleeding.
Option C: Blood transfusion is a secondary, resuscitative measure to replace lost blood volume and oxygen-carrying capacity. It is critical but can only be done after the source of the bleeding is controlled. You must plug the leak before refilling the container.
Option D: Administering oxygen is a supportive measure to improve tissue oxygenation, which may be compromised due to blood loss. However, it does not stop the bleeding itself, which is the primary life-threatening problem.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Prioritization of nursing interventions for acute hemorrhage control in the correct sequence, documenting the action clearly, and monitoring for the expected response.
In trauma care, the mnemonic has shifted from ABC (Airway, Breathing, Circulation) to ABC or MARCH, where the initial 'C' or 'M' stands for Catastrophic Hemorrhage (Massive Hemorrhage). This emphasizes that stopping massive external bleeding is the absolute first priority.
A nurse must be able to act immediately to control bleeding with available materials. Delaying direct pressure to search for sterile supplies or to perform secondary tasks can lead to irreversible shock and death.
What if? If direct pressure fails to control severe arterial bleeding in a limb, the next priority intervention would be the application of a commercial or improvised tourniquet proximal (above) the wound.

How to Approach the Question

First, identify the core clinical problem presented in the stem. Here, it is 'active bleeding,' which is a life-threatening emergency.
Next, recognize that the question asks for the 'priority' intervention. This means you must select the most critical, immediate action that will have the greatest impact on survival.
Evaluate each option's function. Does the action directly address the problem (stopping blood loss), or does it address a consequence of the problem (lost volume, low oxygen)?
Applying direct pressure is the only option that directly stops the loss of blood from the body.
Eliminate the other options because they are either irrelevant (DVT sleeves) or are secondary, supportive treatments (transfusion, oxygen) that should be performed after the bleeding is controlled.

Concept Tested & Keywords

Concept Tested: Prioritization of nursing interventions for acute hemorrhage control.
Stem keywords: active bleeding, lower limb, priority nursing intervention
Lead-in keywords: priority