Which of the following is included in the management of hemarthrosis in a child with hemophilia A?
Keep affected extremity below the level of the heart
Use of topical analgesic cream on the painful area
Instructing the parent to call their health care provider to obtain a plan of care
Prompt infusion of Factor VIII
The Correct Answer is D
Choice A reason:
Keeping the affected extremity below the level of the heart is not recommended in the management of hemarthrosis in a child with hemophilia A. Elevating the affected limb can help reduce swelling and pain by promoting venous return and decreasing pressure in the joint.
Choice B Reason:
The use of topical analgesic cream on the painful area is not a primary treatment for hemarthrosis in hemophilia A. While it may provide some temporary relief, it does not address the underlying issue of bleeding within the joint. The primary treatment involves replacing the missing clotting factor.
Choice C Reason:
Instructing the parent to call their health care provider to obtain a plan of care is important, but it is not the immediate management step for hemarthrosis. Prompt treatment with clotting factor replacement is crucial to stop the bleeding and prevent joint damage.
Choice D Reason:
Prompt infusion of Factor VIII is the primary treatment for hemarthrosis in a child with hemophilia A. This treatment helps to replace the missing clotting factor, stop the bleeding, and prevent further joint damage. Early intervention is essential to minimize complications and promote healing.
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Related Questions
Correct Answer is B
Explanation
Choice A reason:
Compartment syndrome is a condition where increased pressure within a muscle compartment leads to decreased blood flow, which can cause muscle and nerve damage. It is typically associated with severe trauma, fractures, or crush injuries. The symptoms include severe pain, swelling, and decreased sensation or movement in the affected limb. In this case, the child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are more indicative of an infection rather than compartment syndrome.
Choice B Reason:
Osteomyelitis is an infection of the bone, which can occur following an injury or infection elsewhere in the body. The symptoms include redness, swelling, tenderness, and pain in the affected area, along with fever and elevated WBC. Given the child’s history of a spider bite and the presence of redness, swelling, tenderness, and elevated WBC, osteomyelitis is the most likely diagnosis. The unremarkable X-ray does not rule out osteomyelitis, as early stages of the infection may not show changes on X-ray.
Choice C Reason:
Osteogenesis imperfecta, also known as brittle bone disease, is a genetic disorder characterized by fragile bones that break easily. It is not associated with infections or elevated WBC. The symptoms of osteogenesis imperfecta include frequent fractures, blue sclerae, and hearing loss. The child’s symptoms of redness, swelling, and tenderness following a spider bite, along with an elevated WBC, are not consistent with osteogenesis imperfecta.
Choice D Reason:
Juvenile idiopathic arthritis (JIA) is a type of arthritis that occurs in children. It is characterized by persistent joint inflammation, pain, and swelling. While JIA can cause joint tenderness and swelling, it is not typically associated with a recent injury or infection, such as a spider bite. Additionally, JIA does not usually cause elevated WBC. The child’s symptoms are more indicative of an infection, making osteomyelitis the more likely diagnosis.
Correct Answer is A
Explanation
Choice A reason:
Cleansing the suture line, maintaining an upright position, and using arm restraints are crucial aspects of postoperative care for an infant after cleft lip repair. Cleansing the suture line helps prevent infection and promotes healing. Keeping the infant in an upright position reduces the risk of aspiration and helps with breathing. Arm restraints prevent the infant from touching or rubbing the surgical site, which could disrupt the healing process.
Choice B Reason:
Mouth irrigations and a prone position are not recommended for postoperative care after cleft lip repair. Mouth irrigations can be too harsh for the delicate surgical site, and a prone position (lying face down) can increase the risk of aspiration and breathing difficulties. Cleansing the suture line is important, but the other aspects of this choice are not suitable.
Choice C Reason:
Frequent oral suction and spoon feeding are not appropriate for an infant after cleft lip repair. Oral suction can be too aggressive and may damage the surgical site. Spoon feeding is not recommended as it can put pressure on the healing lip. Giving a teething toy is also not advisable as it can cause the infant to put objects in their mouth, potentially harming the surgical site.
Choice D Reason:
Arm restraints are indeed necessary to prevent the infant from touching the surgical site. However, postural drainage and mouth irrigations are not suitable for postoperative care after cleft lip repair. Postural drainage is not relevant to this condition, and mouth irrigations can be too harsh for the healing tissue.
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