A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take?

Select all that apply.

Assess for changes in level of consciousness.

Administer factor VIII.

Perform passive range of motion hourly.

Administer factor IX.

Apply a warming blanket over the child.

Answer and Explanation

Correct Answer : A,B

A. Assess for changes in level of consciousness. Abdominal trauma can lead to internal bleeding, which might increase intracranial pressure if bleeding occurs in the brain. Monitoring for neurological changes is essential.
B. Administer factor VIII. Hemophilia A results from factor VIII deficiency, and replacing it prevents further bleeding.
C. Perform passive range of motion hourly. Movement may exacerbate bleeding into the joints or injured tissues. Rest is essential during acute bleeding episodes.
D. Administer factor IX. Factor IX is used for hemophilia B, not hemophilia A.
E. Apply a warming blanket over the child. Hypothermia management may be necessary in some trauma cases, but there is no indication it is needed here based on the scenario provided.

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Correct Answer is D

Explanation

A. "I will ensure that my child takes a 1-hour nap each day." Prolonged inactivity, like frequent naps, may increase joint stiffness. Physical activity should be encouraged to maintain joint mobility.
B. "I will give my child prednisone as needed for pain." Prednisone is not typically used as needed for pain. NSAIDs are the first-line treatment for inflammation and pain in JIA.
C. "I will apply cool compresses to my child's painful joints during exacerbations." Warm compresses, not cool, are typically more effective in relieving joint stiffness in JIA.
D. "I will have my child wear splints during the night." Wearing splints at night helps maintain joint position and prevent contractures.

A. Cover the equipment used in the infant's care prior to the parents' first visit. B. Reduce the parents' distress by limiting the duration of their visit. C. Avoid leaving the parents alone with the infant during their visit. D. Involve the parents in the infant's caregiving activities during their visit.

Correct Answer is D

Explanation

A. Cover the equipment used in the infant's care prior to the parents' first visit: While this might reduce visual distress, it does not directly support the grieving process or involve the parents in meaningful interactions.
B. Reduce the parents' distress by limiting the duration of their visit: Limiting visit time may increase distress by reducing opportunities for the parents to process emotions.
C. Avoid leaving the parents alone with the infant during their visit: Parents may value privacy to express their feelings and bond with the infant without outside observation.
D. Involve the parents in the infant's caregiving activities during their visit. Involving parents in caregiving helps them feel connected to their child and provides meaningful time to bond, which supports healthy grieving.

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A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take? Select all that apply.

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A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take?

Select all that apply.