The nurse is caring for a child diagnosed with Tetralogy of Fallot who has positioned themselves in a squatting position. The nurse understands this position:

Choice A reason: Applying a cold pack to the affected area is the most appropriate intervention for managing hemarthrosis (bleeding into the joint) in a patient with haemophilia A. Cold therapy helps reduce pain, swelling, and inflammation by constricting blood vessels, which can slow down bleeding. This intervention also provides comfort to the patient and helps manage the acute symptoms of hemarthrosis effectively.

Choice B reason: Administering ibuprofen for pain is not recommended for patients with haemophilia A because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding by inhibiting platelet function. Instead, acetaminophen (Tylenol) is often preferred for pain management in these patients as it does not have the same blood-thinning effects.

Choice C reason: Performing range-of-motion exercises is not appropriate during the acute phase of hemarthrosis. Movement and exercise can exacerbate bleeding and increase pain. It is essential to allow the joint to rest and stabilize before considering gentle range-of-motion exercises during the recovery phase. Immediate management should focus on controlling bleeding and reducing inflammation.

Choice D reason: Placing the leg in a dependent position (lower than the heart) is not recommended for managing hemarthrosis. Elevating the affected limb is a better approach as it helps reduce swelling and pain by promoting venous return and minimizing blood flow to the affected area. The dependent position can increase blood flow to the joint, potentially worsening the bleeding and swelling.

Choice A reason: The designation T3 indicates that the patient has had three full-term births, defined as births that occurred between 37 and 42 weeks of gestation. This is part of the standard obstetric history notation.

Choice B reason: The notation P1 means the patient has had one preterm birth, which is defined as a birth that occurred between 20 weeks and 36 weeks 6 days of gestation. This is an important part of understanding the patient's pregnancy history.

Choice C reason: A2 denotes that the patient has had two pregnancy losses before 20 weeks of gestation, which can include miscarriages or stillbirths. This is crucial for assessing the patient's reproductive health history.

Choice D reason: There is no indication from the notation G6, T3, P1, A2, L4 that the patient has had three elective abortions. Elective abortions would be noted differently in the patient's chart if they were part of the obstetric history.

Choice E reason: The notation L4 indicates that the patient currently has four living children. This is an important part of the patient's obstetric history as it gives insight into their childbearing outcomes.