A nurse is preparing to obtain a blood sample for an Hgb from a child who has hemophilia. Which of the following actions should the nurse plan to take?

Apply a transparent dressing to the site after the venipuncture.

Apply a cold compress to the site prior to obtaining the sample.

Perform an Allen test prior to obtaining the blood sample.

Obtain the sample using venipuncture.

Answer and Explanation

The Correct Answer is D

A. Apply a transparent dressing to the site after the venipuncture. A pressure dressing is more appropriate to control bleeding in a child with hemophilia.
B. Apply a cold compress to the site prior to obtaining the sample. Cold compresses reduce swelling but are not required prior to venipuncture.
C. Perform an Allen test prior to obtaining the blood sample. An Allen test is used to evaluate arterial circulation before arterial blood sampling, not for venipuncture.
D. Obtain the sample using venipuncture. Venipuncture is preferred over heel sticks or finger pricks for children with hemophilia because it minimizes trauma and bleeding.

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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. Instruct the child to gargle using salt water every 4 hr. B. Give the child fluids using a straw. C. Ask the child to take deep breaths and cough every 30 min. D. Apply an ice collar to the child's neck.

Correct Answer is D

Explanation

A. Instruct the child to gargle using salt water every 4 hr: Gargling can irritate the surgical site and increase the risk of bleeding.
B. Give the child fluids using a straw: Using a straw creates suction, which can dislodge the clot and cause bleeding.
C. Ask the child to take deep breaths and cough every 30 min: Coughing can increase pressure on the surgical site and lead to bleeding.
D. Apply an ice collar to the child's neck. An ice collar reduces swelling, pain, and the risk of bleeding by promoting vasoconstriction.

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