Which of the following would be the most appropriate play activity for a 3-year-old in a spica cast, considering both safety and development?

 

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.

The correct answer is b. Preadolescent growth spurt

Choice A reason:

Idiopathic scoliosis is not typically noticeable when a toddler begins to walk. At this stage, the spine is still developing, and any curvature is usually not significant enough to be detected. Idiopathic scoliosis most commonly becomes noticeable during periods of rapid growth, which occur later in childhood.

Choice B Reason:

The preadolescent growth spurt is the period when idiopathic scoliosis becomes most noticeable. This is because the rapid growth during this time can exacerbate the curvature of the spine. Idiopathic scoliosis often becomes apparent between the ages of 10 and 18 years, when children experience significant growth spurts.

Choice C Reason:

Late adolescence is not the period when idiopathic scoliosis becomes most noticeable. By this time, most children have completed their major growth spurts, and any scoliosis would likely have been detected earlier. The condition is typically identified during the preadolescent growth spurt.

Choice D Reason:

The newborn period is not associated with the development of idiopathic scoliosis. While congenital scoliosis can be present at birth, idiopathic scoliosis develops later in childhood, particularly during periods of rapid growth.