A nurse is caring for a client with hemophilia.
The client reports pain, swelling, and reduced range of motion in their joints.
Which of the following statements by the nurse is appropriate?

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:

Easy bruising is a common clinical manifestation of hemophilia.

Patients with hemophilia have difficulty forming blood clots, which makes them prone to bleeding into the soft tissues, leading to easy bruising.

This choice is correct.

Choice B rationale:

Hematuria (blood in the urine) is not a typical clinical manifestation of hemophilia.

Hemorrhaging in the urinary tract is uncommon in hemophilia, so this choice is incorrect.

Choice C rationale:

Joint pain and swelling are characteristic clinical manifestations of hemophilia.

Bleeding into the joints can cause pain, swelling, and limited range of motion.

This choice is correct.

Choice D rationale:

Elevated factor VIII levels are not an expected clinical manifestation of hemophilia.

In fact, individuals with hemophilia have reduced levels of factor VIII due to the genetic mutation that causes the condition.

This choice is incorrect.

Choice E rationale:

Spontaneous nosebleeds are a common clinical manifestation of hemophilia.

The fragile blood vessels in the nose can rupture easily, leading to spontaneous nosebleeds.

This choice is correct.