A nurse is developing a plan of care for a 4-year-old child who has hemophilia and is experiencing acute hemarthrosis. Which of the following interventions should the nurse include in the plan?
Have the child perform passive range-of-motion exercises.
Administer aspirin as needed for pain.
Place ice packs on the affected joints.
Position the lower extremities below the level of the heart.
The Correct Answer is C
A. Have the child perform passive range-of-motion exercises: This is not recommended during acute hemarthrosis in hemophilia because it can further exacerbate bleeding and increase joint damage. Passive range-of-motion exercises should be avoided until bleeding has been adequately controlled.
B. Administer aspirin as needed for pain: Aspirin is not recommended for pain management in hemophilia due to its antiplatelet effects, which can further prolong bleeding. Instead, acetaminophen (Tylenol) or other nonsteroidal anti-inflammatory drugs (NSAIDs) that do not affect clotting mechanisms may be used for pain relief.
C. Place ice packs on the affected joints: This is a recommended intervention. Ice packs can help reduce inflammation and swelling in the affected joints, providing pain relief and potentially slowing down bleeding. However, it's important to ensure that the ice pack is wrapped in a cloth or towel to prevent direct contact with the skin, which could cause tissue damage.
D. Position the lower extremities below the level of the heart: This is not recommended. Elevating the affected extremity above the level of the heart can help reduce swelling and minimize bleeding. Placing the lower extremities below the level of the heart could potentially increase bleeding.
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Related Questions
Correct Answer is C
Explanation
A. "What is your pain level right now?": This response doesn't directly address the child's question about mortality and may deflect the conversation away from the child's concerns. While assessing pain is important, it should not be the immediate response to a question about mortality.
B. "Your doctor will be able to answer your questions tomorrow.": This response delays addressing the child's concerns and may leave the child feeling anxious or unsupported in the meantime. It's important for the nurse to provide immediate support and reassurance when a child expresses fears or worries.
C. "It sounds like you are worried. Tell me what you have been told.": This response acknowledges the child's emotions and invites them to share their thoughts and concerns. It opens up a dialogue between the nurse and the child, allowing the nurse to provide appropriate support and information based on the child's understanding and perspective.
D. "It's natural to worry about death, but you should focus your energy on getting better.": While this response acknowledges the child's worry, it may come across as dismissive or minimizing of the child's concerns about mortality. It's important to validate the child's emotions and offer support rather than redirecting their focus away from their worries.
Correct Answer is D
Explanation
A. "You should give your child aspirin if they report pain at the site."
This statement is incorrect. Aspirin is a blood-thinning medication that can increase the risk of bleeding, which is particularly concerning after a cardiac catheterization procedure. It is not recommended to administer aspirin unless specifically instructed by the healthcare provider.
B. "You can remove the pressure dressing 8 hours after the procedure."
This statement is incorrect. The pressure dressing applied after a cardiac catheterization procedure is typically left in place for a specific period of time, as determined by the healthcare provider. The dressing helps prevent bleeding at the insertion site. It is essential to follow the healthcare provider's instructions regarding the timing of dressing removal.
C. "Your child can soak in the bathtub 24 hours after the procedure."
This statement is incorrect. Immersing the insertion site in water, such as soaking in a bathtub, should be avoided for a certain period after a cardiac catheterization procedure to reduce the risk of infection. The healthcare provider will provide specific instructions on when it is safe for the child to bathe or shower.
D. "Your child should avoid strenuous physical activities for several days."
This statement is correct. After a cardiac catheterization procedure, it is typically recommended to avoid strenuous physical activities for a specified period to allow the insertion site to heal properly and reduce the risk of complications such as bleeding or hematoma formation.
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