The nurse is caring for a patient with haemophilia A who is experiencing hemarthrosis of the knee. Which intervention will the nurse perform?

Apply a cold pack to the affected area.

Administer ibuprofen for pain.

Perform range-of-motion exercises.

Place the leg in a dependent position.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is C

Explanation

Choice A reason: Vaginal delivery after 12 hours of Labor, while potentially exhausting for the mother, does not inherently place her at a higher risk for postpartum haemorrhage compared to other factors. Prolonged Labor can be associated with certain complications, but it is not the most direct indicator of increased haemorrhage risk in the postpartum period.

Choice B reason: Primiparity, or being a first-time mother, delivered at full dilation of 10 cm is a normal part of the childbirth process. While first-time mothers might experience longer Labor durations, this alone does not signify a higher risk for postpartum haemorrhage. Risk factors for haemorrhage typically involve conditions or interventions that impact the uterus's ability to contract effectively after birth.

Choice C reason: Manual extraction of the placenta is a significant risk factor for postpartum haemorrhage. When the placenta does not detach and deliver on its own, manual removal is necessary, which can cause trauma to the uterus and interfere with its ability to contract properly after delivery. The lack of effective uterine contraction can lead to increased bleeding, making this a higher risk scenario for postpartum haemorrhage.

A. Seek medical attention if the newborn has a fever. B. Watch out for yellowing of the skin or eyes. C. Adhere to the recommended vaccine schedule. D. Administer factor VIII replacement as indicated. E. Provide oral penicillin V potassium to prevent infection.

Correct Answer is ["A","B","C","E"]

Explanation

Choice A reason: Seeking medical attention if the newborn has a fever is crucial for children with sickle cell anaemia. Fever can be an early sign of infection, and children with sickle cell anaemia are at a higher risk for infections. Prompt medical evaluation and treatment are necessary to prevent severe complications.

Choice B reason: Watching out for yellowing of the skin or eyes (jaundice) is important because it can indicate homolysis, a common issue in sickle cell anaemia where red blood cells break down rapidly. Identifying jaundice early allows for timely medical intervention to address underlying causes and prevent further complications.

Choice C reason: Adhering to the recommended vaccine schedule is essential for protecting children with sickle cell anaemia from preventable infections. Their immune systems are often compromised, making them more susceptible to infections that vaccines can help prevent.

Choice D reason: Administering factor VIII replacement is not relevant to sickle cell anaemia. Factor VIII replacement is a treatment for haemophilia, a different blood disorder. This intervention is not applicable in the context of sickle cell anaemia education.

Choice E reason: Providing oral penicillin V potassium to prevent infection is a standard recommendation for children with sickle cell anaemia. Daily prophylactic penicillin helps reduce the risk of serious infections, particularly from Streptococcus pneumoniae, which can be life-threatening in these patients.

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The nurse is caring for a patient with haemophilia A who is experiencing hemarthrosis of the knee. Which intervention will the nurse perform?

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