During management of epistaxis (nose bleeding), which of the following actions is NOT a part of the nursing officer’s role?

Appeared in: BSF Staff Nurse - 2021

Explanation

Asking the patient to tilt the head backward is a contraindicated action during the management of epistaxis.
This incorrect position causes blood to drain down the back of the throat (posterior pharynx).
This drainage creates a significant risk of swallowing blood, which can lead to nausea and vomiting, or aspirating blood into the lungs, which can cause serious respiratory complications like pneumonia.

Option A: This is a correct and essential action. Having the patient sit up and lean forward uses gravity to help drain blood out of the nostrils instead of down the throat.
Option B: This is a correct and primary intervention. Pinching the soft, fleshy part of the nose for 10-15 minutes applies direct pressure to Kiesselbach's plexus, the most common site of anterior nosebleeds, to promote hemostasis (clotting).
Option C: This is a correct and necessary instruction. When the nose is being pinched to control bleeding, the patient cannot breathe through it. Instructing them to breathe through their mouth is crucial for maintaining their airway and comfort.

Clinical Relevance

Nursing practice connection: Knowing First Aid Management of Epistaxis (Nosebleed) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Properly managing epistaxis is a critical first-aid skill for nurses to prevent serious complications like aspiration pneumonia, which can result from incorrect positioning.
Patient education is a key nursing role. Nurses must often correct the common and dangerous misconception that one should tilt the head back during a nosebleed.
What if the patient is unconscious or cannot sit up? The patient should be placed in the recovery position (on their side) to allow blood to drain from the mouth and prevent aspiration.

How to Approach the Question

First, identify the negative keyword 'NOT' in the question stem. This indicates you are looking for the action that is incorrect or contraindicated.
Next, recall the primary goals of first aid for epistaxis: 1) Stop the bleeding and 2) Prevent complications, especially aspiration.
Systematically evaluate each option against these two goals.
Option A (lean forward) prevents aspiration. This is correct.
Option B (apply pressure) helps stop the bleeding. This is correct.
Option C (breathe through mouth) is necessary while pressure is applied. This is correct.

Concept Tested & Keywords

Concept Tested: First Aid Management of Epistaxis (Nosebleed)
Stem keywords: epistaxis, nose bleeding, management, nursing officer's role
Lead-in keywords: NOT
Negative lead-in flag: The question asks for an action that is NOT part of the standard procedure, requiring you to identify the contraindicated step.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 42-44

Practise the full BSF Staff Nurse - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.