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 D

Explanation

Choice A reason: Developing a plan of care with the child and family is important, but it does not explicitly address the need for cultural competence. This approach is cantered around collaboration rather than cultural sensitivity.

Choice B reason: Providing future-based care for culturally diverse children is vague and does not directly indicate an understanding or application of cultural competence in the current care situation.

Choice C reason: Treating all children the same regardless of their culture is contrary to the principles of culturally competent care. Culturally competent care involves recognizing and respecting the cultural differences that impact the child's health and tailoring the care to meet those unique needs.

Choice D reason: Assessing the child's culture and providing care based on the findings demonstrates an understanding and application of culturally competent care. This approach ensures that the care is respectful of and responsive to the cultural needs of the child and family.

A. My baby has a higher risk of developing jaundice. B. This procedure was required because my baby was breech. C. The vacuum was required because I did not dilate past 6 centimetres. D. My baby’s head will be cone-shaped for about 2 months.

Correct Answer is A

Explanation

Choice A reason: This statement indicates the parent's understanding that vacuum-assisted deliveries can sometimes lead to an increased risk of jaundice. The use of a vacuum can cause bruising on the baby's scalp, which can lead to the breakdown of red blood cells, thereby increasing bilirubin levels. Elevated bilirubin levels can cause jaundice in newborns. Recognizing this potential risk and monitoring the baby for signs of jaundice is an essential aspect of post-delivery care.

Choice B reason: Stating that the procedure was required because the baby was breech is incorrect. Vacuum-assisted delivery is typically used in cases where the baby is in a cephalic (head-first) position and there are difficulties in progressing through the birth canal, such as when the mother is exhausted, or the baby needs to be delivered quickly due to fatal distress. Breech presentations often necessitate a caesarean section instead of a vacuum-assisted delivery.

Choice C reason: The assertion that the vacuum was required because the mother did not dilate past 6 centimetres is inaccurate. Vacuum-assisted delivery is not related to cervical dilation but rather to difficulties encountered during the second stage of Labor (pushing phase). The decision to use a vacuum is made when the baby is in the birth canal, and additional assistance is needed to facilitate delivery.

Choice D reason: Stating that the baby’s head will be cone-shaped for about 2 months is also incorrect. While a vacuum-assisted delivery can result in a temporary cone-shaped head (known as "caput succedaneum" or melding), this typically resolves within a few days to weeks after birth. It is not expected to last for two months. Proper education should clarify the temporary nature of the head shape changes.

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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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Naxlex Comprehensive Predictor Exams

The paediatric nurse is teaching the student nurse about culturally competent care. Which action will the student nurse identify as consistent with this type of care?

Correct Answer is D

Explanation

The nurse is teaching a parent who delivered the baby with vacuum-assisted delivery. Which of the following statements will confirm to the nurse that the teaching was effective?

Correct Answer is A

Explanation

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