Question

Direct pressure to a deep laceration on the client's lower leg has failed to stop the bleeding. The nurse's next action should be able to: A. Place a tourniquet proximal to the laceration B. Elevate the leg above the level of the heart C. Cover the laceration and apply an ice compress D. Apply pressure to the femoral artery

Short answer

Answer: Apply pressure to the femoral artery.

Step-by-step solution

Evaluate Option A

A tourniquet is a compressing device used to limit blood flow in an extremity. Placing a tourniquet proximal to the laceration (closer to the heart than the laceration) can indeed help to limit blood flow to the wound and control bleeding. However, using a tourniquet should be employed only as a last resort when other methods have failed because it can lead to tissue damage and, in worst cases, the loss of the limb.

Evaluate Option B

Elevating the leg above the level of the heart can help to utilize gravity to reduce blood flow to the area, thus helping to control bleeding. Since elevating the leg is less invasive and harmful compared to using a tourniquet, this option might be considered before the tourniquet, so this option is more favorable than Option A.

Evaluate Option C

Covering the laceration and applying an ice compress can help to reduce swelling, which might indirectly slow down the blood flow, but it is not effective enough in stopping the bleeding. As bleeding control should be prioritized over swelling reduction, this option is not suitable in this situation.

Evaluate Option D

Applying pressure to the femoral artery can be effective in stopping the blood flow temporarily, as the femoral artery provides blood supply to the leg. Since pressing the femoral artery is less invasive than applying a tourniquet and can be done quickly, this option might be considered before the tourniquet and elevation of the leg in some cases.

Choose the best option and explain the reasoning

Based on the analysis, the appropriate action for the nurse should be to "Apply pressure to the femoral artery" (Option D). This option is less invasive compared to using a tourniquet (Option A) and provides immediate bleeding control (unlike Option B, where the elevated position might take a little time to show its effect). Option C is less effective in stopping the bleeding compared to Options A, B, and D.