A client with hemophilia experiences mucosal bleeding episodes such as epistaxis and oral bleeding.
Which drug, used as adjunctive therapy to inhibit the breakdown of fibrin clots, should the nurse consider?
Factor replacement therapy.
Desmopressin acetate (DDAVP)
Aminocaproic acid.
Gene therapy.
The Correct Answer is C
Choice A rationale:
Factor replacement therapy, such as the administration of factor VIII concentrates, is the primary treatment for managing bleeding episodes in patients with hemophilia.
However, it does not specifically inhibit the breakdown of fibrin clots, which is the primary role of aminocaproic acid.
Choice B rationale:
Desmopressin acetate (DDAVP) is used to stimulate the release of factor VIII and von Willebrand factor from endothelial cells.
While it can help in some cases, it may not be the most effective choice for mucosal bleeding episodes like epistaxis and oral bleeding, where aminocaproic acid is more commonly used.
Choice C rationale:
Aminocaproic acid is an antifibrinolytic medication that inhibits the breakdown of fibrin clots.
It is particularly useful in managing mucosal bleeding episodes in patients with hemophilia, such as epistaxis and oral bleeding, by preventing the premature dissolution of clots and promoting hemostasis.
Choice D rationale:
Gene therapy is an emerging treatment for hemophilia, but it does not directly address the breakdown of fibrin clots.
It aims to provide a long-term solution by introducing functional clotting factor genes into the patient's body, but it may not be the immediate choice for managing acute bleeding episodes.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
The client has a normal coagulation profile.
This choice is incorrect because the client's prolonged PTT suggests a problem with the intrinsic pathway of coagulation, which is typical in hemophilia.
A normal coagulation profile would show normal values for both PTT and PT.
Choice B rationale:
The client may have a vitamin K deficiency.
This choice is not applicable in this context.
A vitamin K deficiency primarily affects the extrinsic pathway of coagulation, leading to an elevated PT, but it does not typically affect the PTT, which is prolonged in hemophilia.
Choice C rationale:
The client likely has hemophilia.
This is the correct choice.
Hemophilia is characterized by a deficiency or dysfunction of clotting factors, most commonly factor VIII (hemophilia A) or factor IX (hemophilia B)
Prolonged PTT with normal PT is a classic laboratory finding in hemophilia.
Choice D rationale:
The client is at risk for thrombosis.
This choice is incorrect.
Hemophilia is associated with bleeding tendencies, not an increased risk of thrombosis.
Prolonged PTT indicates a reduced ability to form clots, making thrombosis less likely.
Correct Answer is D
Explanation
Choice A rationale:
Hemophilia A and hemophilia B are both types of hemophilia, but hemophilia A is actually less common than hemophilia B.
The prevalence of hemophilia A is about 1 in 5,000 males, whereas hemophilia B occurs in about 1 in 25,000 males.
Therefore, this statement is incorrect.
Choice B rationale:
Hemophilia is not inherited through a defective gene on the Y chromosome.
Hemophilia is an X-linked recessive genetic disorder, which means it is caused by a mutation in genes located on the X chromosome, not the Y chromosome.
This statement is incorrect.
Choice C rationale:
This statement is correct.
Males inherit hemophilia from their mothers who carry the defective gene on one of their X chromosomes.
However, it's important to note that females can also be carriers of the gene and can pass it on to their sons.
This statement does not indicate a need for further teaching.
Choice D rationale:
This statement is incorrect.
While it is very rare for females to have hemophilia, it is not impossible.
Females can inherit hemophilia if they have two affected X chromosomes or if they inherit one affected X chromosome and one affected Y chromosome.
Therefore, this statement does not indicate a need for further teaching.
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