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 C

Explanation

A. "I will give lansoprazole 30 minutes after their feeding." Lansoprazole should be administered 30 minutes before feedings to effectively reduce stomach acid.
B. "I will lay my baby on her side after feedings." Side-lying positioning increases the risk of sudden infant death syndrome (SIDS). The infant should be placed on their back.
C. "I will add rice cereal to my baby's feedings." Adding rice cereal can thicken the formula, helping to reduce reflux episodes.
D. "I will use a nipple that has a wide base to feed them." While wide-based nipples can be helpful for latch during breastfeeding, they do not significantly impact GER management.

A. Initiate passive range of motion exercises. B. Administer aspirin PRN for pain. C. Offer the toddler an electronic tablet with games. D. Place a warm pack on joints prior to activity.

Correct Answer is C

Explanation

A. Passive range of motion exercises are contraindicated during acute joint swelling and bleeding, as they can exacerbate bleeding into the joints (hemarthrosis).
B. Aspirin is contraindicated as it can impair platelet function and worsen bleeding in clients with bleeding disorders.
C.Offering an electronic tablet helps to distract the toddler and prevent unnecessary movement, which could worsen joint bleeding or discomfort.
D. Warm packs are contraindicated during acute joint swelling; cold packs should be used to reduce bleeding and swelling.

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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.