Management of Epistaxis includes, EXCEPT?

Appeared in: KGMU 2023

Explanation

Leaning backward is contraindicated during a nosebleed as it directs blood flow down the posterior pharynx.
This creates a significant risk of aspirating blood into the lungs, which can lead to pneumonia or airway obstruction.
Swallowing large amounts of blood can also irritate the stomach, leading to nausea and vomiting.

Option B: This is a correct and essential step for managing epistaxis, not an exception.
Option C: This is a necessary action, not an exception.
Option D: This is a primary intervention, not an exception.

Visual 1: Illustration - A diagram showing two figures. One correctly leaning forward and pinching their nose for epistaxis management, and the other incorrectly leaning backward, with arrows indicating the dangerous path of blood toward the throat and airway.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain First Aid Management of Epistaxis (Nosebleed) as background academic context rather than a clinical decision trigger.
Proper patient positioning during epistaxis is a critical nursing intervention to ensure patient safety and prevent aspiration, a potentially life-threatening complication.
Nurses must be able to quickly correct patient or family member misconceptions, such as the common but dangerous advice to lean backward.
What if? If the patient is unconscious or has a decreased level of consciousness, they should be placed in the recovery position (on their side) to allow blood to drain from the mouth and prevent aspiration, while immediate medical help is sought.

How to Approach the Question

First, identify the keywords in the stem: 'Management of Epistaxis' and the negative lead-in 'EXCEPT'.
The word 'EXCEPT' signals that three of the options are correct actions, and one is an incorrect or contraindicated action. Your task is to find the incorrect one.
Evaluate each option based on standard first aid and nursing protocols for a nosebleed.
Recall that the primary goals are to stop the bleeding and prevent complications like aspiration. Leaning forward, pinching the nose, and breathing through the mouth are all part of the correct procedure.
Identify that leaning backward would cause blood to go down the throat, which is dangerous. This makes it the incorrect action and thus the correct answer to the 'EXCEPT' question.

Concept Tested & Keywords

Concept Tested: First Aid Management of Epistaxis (Nosebleed)
Stem keywords: Management, Epistaxis
Lead-in keywords: EXCEPT
Negative lead-in flag: The question asks for the action that should NOT be taken (EXCEPT).

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Practise the full KGMU 2023

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