Plasma expanders are used in?

SCTIMST Staff Nurse - 2016

Medical & Surgical Nursing

Medium

Appeared in: SCTIMST Staff Nurse - 2016

Explanation

The primary function of plasma expanders is to restore intravascular volume in cases of hypovolemic shock.
Severe trauma is a leading cause of hypovolemic shock due to hemorrhage (blood loss) and fluid shifts.
Plasma expanders (colloids) have large molecules that stay in the bloodstream, exerting oncotic pressure to hold fluid in the vessels and stabilize blood pressure.
This intervention is a critical temporary measure to maintain organ perfusion while the underlying cause of bleeding is addressed and blood products are prepared.

Option A: Severe anaemia is a deficiency in oxygen-carrying capacity (low red blood cells/hemoglobin). Plasma expanders only provide volume and would dilute the existing red blood cells, potentially worsening tissue hypoxia.
Option C: Pulmonary oedema is a condition of fluid overload in the lungs. Administering a plasma expander would increase the intravascular volume and hydrostatic pressure, forcing more fluid into the alveoli and severely worsening the condition.
Option D: In cardiac failure, the heart muscle is unable to pump effectively. Increasing the blood volume with a plasma expander increases preload, which places additional strain on the already failing heart, exacerbating the failure and potentially causing acute pulmonary oedema.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indications and contraindications of plasma expanders as background academic context rather than a clinical decision trigger.
When administering plasma expanders for trauma, nurses must use large-bore IV catheters (e.g., 16 or 18 gauge) to allow for rapid infusion.
Continuous monitoring is essential. The nurse must frequently assess blood pressure, heart rate, urine output, and mental status to evaluate the effectiveness of volume resuscitation.
A critical nursing responsibility is to monitor for signs of fluid overload, especially if large volumes are given rapidly. This includes listening for new crackles in the lungs, observing for jugular venous distention (JVD), and noting the development of peripheral edema.

How to Approach the Question

First, identify the core concept of the question. The question asks for the correct use of 'plasma expanders'.
Recall the primary function of a plasma expander: to increase the volume of fluid within the blood vessels (intravascular volume).
Analyze each option based on its pathophysiology and determine if increasing intravascular volume would be beneficial or harmful.
Option A (Severe anaemia): This is a lack of red blood cells, not volume. Adding volume would be unhelpful and potentially harmful. Eliminate.
Option B (Severe trauma): This often involves significant blood/fluid loss (hypovolemia). Increasing volume is the primary goal. This is a strong candidate.
Option C (Pulmonary oedema): This is a state of fluid overload in the lungs. Adding more volume would be dangerous. Eliminate.

Concept Tested & Keywords

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E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 307-309

E6 Pharmacology Nurses Shanbhag 3e p. 124-126