A child with hemophilia is experiencing a bleeding episode. After applying pressure to the bleeding site, what is the priority intervention?

Encourage active range of motion exercises

Administer antibiotics as prescribed

Apply heat to the affected area

Administer factor replacement therapy as prescribed

Answer and Explanation

The Correct Answer is D

A. Encourage active range of motion exercises is incorrect. Active range of motion exercises should be avoided during a bleeding episode, as it may exacerbate the bleeding or cause further injury. Hemophilia requires rest and stabilization during bleeding episodes.

B. Administer antibiotics as prescribed is incorrect. Antibiotics are typically not needed for bleeding episodes unless there is a risk of infection from a wound. The primary concern during a bleeding episode is managing the bleeding, not preventing infection.

C. Apply heat to the affected area is incorrect. Heat is not recommended during a bleeding episode as it can increase blood flow and worsen bleeding. Instead, ice may be applied to help control bleeding and reduce swelling.

D. Administer factor replacement therapy as prescribed is correct. The priority in managing bleeding in a child with hemophilia is to administer factor replacement therapy, which helps to replace the missing clotting factors in the blood, enabling proper clot formation and stopping the bleeding.

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Correct Answer is D

Explanation

A. While alterations in pupil size and reactivity are signs of increased ICP, increased motor response is not a late sign and typically reflects an early sign of brain dysfunction.

B. Extension or flexion posturing may occur with increased ICP, but weight gain is not a sign of ICP.

C. Tachycardia can occur early in ICP, but it does not typically present as a late sign. Altered pupil size and reactivity may occur, but these are not exclusive to late ICP signs.

D. This is the correct answer. Cheyne-Stokes respirations, which are characterized by alternating periods of apnea and deep breathing, are a late sign of increased ICP in infants. Additionally, changes in pupil size (such as dilated or non-reactive pupils) are a late indicator of increasing intracranial pressure.

A. Keep the infant supine. B. Suction the mouth with an oral suction tube. C. Apply elbow restraints and release them periodically. D. Feed the infant with a spoon for 48 hours.

Correct Answer is C

Explanation

A. Keep the infant supine is incorrect. After cleft palate repair, it is generally recommended to keep the infant in a position that minimizes pressure on the surgical site. Keeping the infant in a supine position may cause pressure on the repaired area, so side or semi-prone positioning is preferred.

B. Suction the mouth with an oral suction tube is incorrect. Suctioning should be avoided unless absolutely necessary because it can irritate the surgical site and cause trauma to the newly repaired palate.

C. Apply elbow restraints and release them periodically is correct. Elbow restraints are commonly used after cleft palate surgery to prevent the infant from touching or putting pressure on the surgical site. These restraints should be periodically released to allow for movement and prevent skin breakdown.

D. Feed the infant with a spoon for 48 hours is incorrect. After cleft palate repair, feeding should be done carefully. Special feeding bottles or cups are typically used to avoid trauma to the surgical site. Feeding with a spoon may cause pressure on the repair and should be avoided.

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A child with hemophilia is experiencing a bleeding episode. After applying pressure to the bleeding site, what is the priority intervention?

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Naxlex Comprehensive Predictor Exams

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased intracranial pressure (ICP) in an infant?

Correct Answer is D

Explanation

A nurse is caring for a 10-month-old infant who is 8 hours postoperative following cleft palate repair. Which of the following interventions should the nurse include in the infant's plan of care?

Correct Answer is C

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