Parents of a school-age child with hemophilia ask the nurse, “Which sports are recommended for children with hemophilia?” Which sport should the nurse recommend?

Swimming is one of the best sports for people with hemophilia because it strengthens the muscles without putting stress on the joints. Swimming is also recommended by most sports physicians and hematologists for patients with hemophilia.

Choice A is wrong because soccer is a contact sport that can cause injuries and bleeding episodes in people with hemophilia. Soccer is not recommended by most sports physicians or hematologists for patients with hemophilia.

Choice C is wrong because basketball is also a contact sport that can lead to injuries and bleeding episodes in people with hemophilia. Basketball may be safe for young children, but the risk increases with the intensity of the game.

Choice D is wrong because football is a collision sport that can cause severe injuries and bleeding episodes in people with hemophilia. Football is not recommended by most sports physicians or hematologists for patients with hemophilia.

Normal ranges for hemophilia are:

• Mild hemophilia: 5% to 40% of normal clotting factor
• Moderate hemophilia: 1% to 5% of normal clotting factor

Severe hemophilia: less than 1% of normal clotting factor

This is because a patent ductus arteriosus is a congenital heart defect that involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. This causes a continuous machinery-like murmur that can be heard on auscultation.

Choice A is wrong because pulmonary stenosis is a narrowing of the pulmonary valve or artery that obstructs blood flow to the lungs. It causes a systolic ejection murmur that is best heard at the upper left sternal border.

Choice C is wrong because the ventricular septal defect is a hole in the wall between the ventricles that allows blood to flow from the left to the right side of the heart. It causes a loud, harsh holosystolic murmur that is best heard at the left lower sternal border.

Choice D is wrong because coarctation of the aorta is a narrowing of the aorta that reduces blood flow to the lower body. It causes a systolic murmur that radiates to the back and weak or absent femoral pulses.