PGIMS Rohtak NO - 2017
Medical & Surgical Nursing
Easy
All are complications of massive blood transfusion, except?
Appeared in: PGIMS Rohtak NO - 2017
Explanation
- Massive blood transfusion does not cause hypercalcemia (high calcium levels).
- It characteristically causes hypocalcemia (low calcium levels).
- This occurs because citrate, the anticoagulant used in stored blood products, binds with (chelates) the patient's free calcium, making it unavailable for physiological functions.
- Therefore, hypercalcemia is the correct answer as it is the exception among the listed options.
Why Other Options Were Wrong
- Option A: Hyperkalemia is a well-known complication of massive blood transfusion.
- Option B: Metabolic alkalosis is a potential complication of massive transfusion.
- Option D: Hypothermia is a very common and immediate complication.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Complications of Massive Blood Transfusion helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses must use a blood warmer for all massive transfusions to prevent hypothermia, which can worsen acidosis and coagulopathy.
- Continuous cardiac monitoring (ECG) is crucial to detect early signs of hyperkalemia (peaked T waves) and hypocalcemia (prolonged QT interval).
- The nurse should anticipate the need for calcium replacement (e.g., calcium gluconate) and have it readily available as per protocol.
How to Approach the Question
- First, identify the keywords in the question: 'massive blood transfusion', 'complications', and the crucial negative lead-in 'except'.
- The goal is to find the option that is NOT a complication of massive transfusion.
- Consider the state of stored blood: it is cold, contains citrate as an anticoagulant, and has a higher concentration of potassium due to leakage from RBCs.
- Evaluate each option against this knowledge:
- Hyperkalemia: Plausible, due to potassium leakage from stored cells.
- Alkalosis: Plausible, as the liver metabolizes citrate to bicarbonate.
Concept Tested & Keywords
- Concept Tested: Complications of Massive Blood Transfusion
- Stem keywords: massive blood transfusion, complications
- Lead-in keywords: except
- Negative lead-in flag: The question uses 'except', asking for the option that is NOT a complication.
Question ID
QDNXt6w-USbu0Pub-VIKw
Reference Book
E6 Medicine Harrison 22e Part 1 p. 953-955
Practise the full PGIMS Rohtak NO - 2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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