A nurse is teaching a client with newly diagnosed hemophilia about home care practices. What statements by the client indicate that teaching has been effective? Select all that apply.
“I will use a soft toothbrush to decrease bleeding from my gums.”.
“If I get a headache, I will take ibuprofen instead of aspirin.”.
“I will report excessive bleeding to my provider and use precautions to protect my head and joints.”.
“I need clotting factor treatments for the rest of my life if a bleed occurs.”.
“I may experience warm, painful joints and should apply heat if that occurs.”.
Correct Answer : A,C
Choice A is correct because using a soft toothbrush can decrease the risk of bleeding from the gums, which is a common site of bleeding for people with hemophilia.
Choice C is correct because reporting excessive bleeding to the provider and using precautions to protect the head and joints are important aspects of home care for hemophilia.
Choice B is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and increase bleeding tendency. People with hemophilia should avoid NSAIDs and use acetaminophen instead for pain relief.
Choice D is wrong because clotting factor treatments are not only needed when a bleed occurs but also as a preventive measure to reduce the frequency and severity of bleeding episodes. People with severe hemophilia need regular clotting factor replacement therapy for the rest of their lives.
Choice E is wrong because warm, painful joints are signs of joint bleeding, which is a serious complication of hemophilia that can lead to permanent joint damage.
People with hemophilia should not apply heat to their joints, but rather use ice packs, compression, elevation and rest to reduce swelling and pain. They should also seek medical attention and receive clotting factor replacement therapy as soon as possible.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
The nurse should use clarifying points made by the patient that are unclear and listening attentively while speaking slowly and clearly as communication techniques when performing a health history.
These techniques help the nurse to gather accurate and comprehensive information from the patient and to establish rapport and trust.
Choice A is wrong because avoiding silences can make the patient feel rushed or interrupted. Silences can be useful to allow the patient to think or express emotions.
Choice D is wrong because sitting approximately two feet away from the client may be too close and invade the personal space of the client. The nurse should maintain a comfortable distance of about 4 to 5 feet from the client, depending on the cultural norms and preferences of the client.
Choice E is wrong because asking the family member to complete the written form may not reflect the true health history of the client. The nurse should obtain the information directly from the client whenever possible, unless the client is unable or unwilling to provide it.
Correct Answer is B
Explanation
To find the rate of the pump in ml/hour, you need to first convert the client’s weight from pounds to kilograms. You can do this by dividing the weight by 2.2046 or multiplying it by 0.454.
For example:
297 lbs / 2.2046 = 134.72 kg or 297 lbs x 0.454 = 134.72 kg
Then, you need to multiply the client’s weight in kilograms by the ordered dose in units/kg/hour to get the total units per hour.
For example:
134.72 kg x 12 units/kg/hour = 1616.64 units/hour
Next, you need to set up a proportion to find the rate of the pump in ml/hour using the supplied medication concentration.
For example:
25,000 units / 500 ml = 1616.64 units / X ml Cross-multiply and solve for X:
25,000 x X = 808320 X = 808320 / 25000 X = 32.33 ml/hour
Finally, you need to round your answer to the nearest tenth of a ml/hour as per the medication administration guidelines.
For example:
32.33 ml/hour ≈ 32.3 ml/hour
Therefore, the rate of the pump is 32.3 ml/hour.
Choice A is wrong because it uses a different conversion factor for pounds to kilograms (1 lb = 0.5 kg) which is not accurate.
Choice C is wrong because it uses a different ordered dose (10 units/kg/hour) which is not what the provider has written.
Choice D is wrong because it uses a different supplied medication concentration (20,000 units in 500 ml) which is not what is available.
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