The father of a 12-year-old girl reports his daughter does not have high self-esteem. He asks for suggestions to increase her feelings of self-worth. Which activity would be most appropriate for the nurse to suggest?

A. Allergic conjunctivitis and allergic rhinitis are not caused by bacteria, so antibiotics offer no benefit. Using antibiotics unnecessarily increases the risk of resistance and exposes the child to unnecessary medication side effects. This statement shows the parent has misunderstood the teaching.

B. The child’s symptoms, itchy, watery eyes, sneezing, and clear rhinorrhea, are classic findings of allergic conjunctivitis and allergic rhinitis, not a viral infection. Viral infections usually involve redness, discomfort, and often systemic symptoms such as fever, malaise, or thicker nasal secretions.

C. Allergic symptoms are caused by an immune response to allergens, not bacteria or viruses. Therefore, antibiotics are not required. Treatment focuses on antihistamines, allergen avoidance, and symptomatic relief, making this the statement that best reflects proper understanding.

D. Allergic conjunctivitis is not contagious, so notifying the daycare is not required. This response suggests the parent believes the condition may spread to others, which indicates misunderstanding of the teaching.

A. Deficiency of Factor IX is responsible for hemophilia B, also called Christmas disease. Like hemophilia A, it is X-linked recessive and primarily affects males, but treatment and factor replacement differ because Factor IX is administered instead of Factor VIII. Misidentifying the factor could lead to inappropriate treatment.

B. Hemophilia A results from a deficiency of Factor VIII, a key protein in the intrinsic pathway of the coagulation cascade. Factor VIII works with Factor IX to activate Factor X, ultimately converting prothrombin to thrombin and fibrinogen to fibrin, forming a stable clot. Without sufficient Factor VIII, the child experiences: Prolonged bleeding after minor cuts or injuries, Spontaneous bleeding episodes, often into joints (hemarthroses) or muscles, Easy bruising, Nosebleeds and prolonged bleeding after dental procedures, Potential life-threatening bleeding if untreated. Factor VIII replacement therapy is the cornerstone of treatment, either prophylactically or during acute bleeding episodes. Education includes proper administration, activity precautions, and early recognition of bleeding.

C. Factor X deficiency is a rare coagulation disorder unrelated to hemophilia A. Deficiency causes bleeding tendencies but involves a different pathway and treatment approach.

D. Stuart-Prower factor refers to Factor X, also not involved in hemophilia A. Confusing this could delay correct treatment and risk severe bleeding.