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?

Choice A rationale:

"It's just a minor issue, and the pain will go away on its own." This statement is not appropriate because joint pain, swelling, and reduced range of motion in a client with hemophilia, known as hemarthrosis, can lead to long-term joint damage and disability if not properly managed.

Downplaying the issue is not in the best interest of the client and may lead to inadequate care.

Choice B rationale:

"Let's apply ice to the affected joint to reduce the swelling." While applying ice to an inflamed joint can help reduce swelling in some cases, it may not be the best immediate approach for a client with hemophilia.

Ice application should be done with caution, as it can potentially worsen bleeding in individuals with hemophilia.

The primary focus should be on assessing the severity of the bleeding, providing appropriate pain management, and consulting with a healthcare provider.

Choice C rationale:

"I'll assess your joint and provide pain management as needed." This is the most appropriate response.

The nurse should assess the client's joint for signs of hemarthrosis, such as swelling, warmth, and reduced range of motion.

Prompt assessment allows for early intervention to manage the bleeding and alleviate pain.

Providing pain management as needed, which may include analgesic medications, is essential to improve the client's comfort and prevent further complications.

Choice D rationale:

"You should perform strenuous exercises to improve joint mobility." Encouraging strenuous exercises in a client with hemophilia who is already experiencing joint pain and swelling is not advisable.

Strenuous exercise can exacerbate bleeding and joint damage.

Instead, the focus should be on gentle range-of-motion exercises and physical therapy, guided by a healthcare provider, to improve joint mobility without increasing the risk of bleeding.

Choice A rationale:

Administering anticoagulants to promote clot formation is not appropriate for the treatment of hemophilia.

Anticoagulants are medications that thin the blood and prevent the formation of blood clots.

However, in individuals with hemophilia, the issue is not the formation of excessive clots but rather the inability to form effective clots due to a deficiency in clotting factors.

Therefore, anticoagulants would worsen the bleeding disorder and are not a suitable intervention.

Choice B rationale:

Encouraging regular physical activity to prevent bleeding episodes is a reasonable recommendation for individuals with hemophilia.

Regular, low-impact physical activity can help strengthen muscles and joints, which may reduce the risk of bleeding episodes and joint damage.

However, this alone is not a treatment for hemophilia but rather a preventive measure.

Choice C rationale:

Administering factor replacement therapy is the primary treatment for hemophilia.

Hemophilia is characterized by a deficiency in specific clotting factors (Factor VIII for Hemophilia A and Factor IX for Hemophilia B)

Replacement therapy involves infusing the missing clotting factor to achieve normal or near-normal levels, allowing the blood to clot properly.

This intervention is crucial in managing and preventing bleeding episodes in individuals with hemophilia.

Choice D rationale:

Administering iron supplements to improve hemoglobin levels is not a direct treatment for hemophilia.

Hemophilia is a clotting disorder, and iron supplements are typically used to treat conditions related to iron deficiency anemia.

While individuals with hemophilia may experience anemia as a result of chronic bleeding, the primary treatment for hemophilia involves addressing the clotting factor deficiency through factor replacement therapy.

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