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 B

Explanation

Choice A reason: While nausea, tiredness, and sleepiness are common during the first trimester of pregnancy, they are typically not signs of an immediate emergency. This patient does not exhibit any alarming symptoms that would require immediate hospital referral.

Choice B reason: Blurred vision and seeing spots during pregnancy can be symptoms of preeclampsia, a potentially dangerous condition characterized by high blood pressure. Preeclampsia can pose serious health risks to both the mother and the baby and requires immediate medical attention.

Choice C reason: Frequent urination is a common symptom in the later stages of pregnancy due to the pressure the growing baby exerts on the bladder. This symptom alone does not indicate an immediate need for hospital evaluation.

Choice D reason: Having 4 to 5 contractions in an hour at 37 weeks of pregnancy can be a sign of early labor. However, unless the contractions are persistent and intensifying, this may not necessitate an immediate hospital referral. The nurse would likely advise the patient to monitor the contractions and come in if they continue or become stronger.

A. Prepare to hang hypotonic fluids. B. Administer oxygen via nasal cannula. C. Provide patient education on acute chest syndrome. D. Give a dose of morphine sulphate.

Correct Answer is B

Explanation

Choice A reason: Preparing to hang hypotonic fluids is not the immediate priority in this situation. While hydration is important for managing sickle cell anaemia, the infant's respiratory distress and low oxygen saturation levels indicate that addressing oxygenation should be the first step. Hypotonic fluids may be considered after stabilizing the patient's breathing and oxygen levels.

Choice B reason: Administering oxygen via nasal cannula is the priority intervention given the infant's symptoms. The infant has increased work of breathing, a fever, coarse crackles upon auscultation, and low oxygen saturation (89%). Providing supplemental oxygen is crucial to improve oxygenation and alleviate respiratory distress. Prompt intervention is necessary to prevent further complications and stabilize the patient's condition.

Choice C reason: Providing patient education on acute chest syndrome is important, but it is not the immediate priority in this emergency situation. Education can be given once the infant's acute symptoms are managed and stabilized. The focus should be on addressing the critical needs first, such as oxygenation and respiratory support.

Choice D reason: Giving a dose of morphine sulphate may help manage pain, but it is not the first priority in this scenario. The infant's respiratory status and oxygenation levels are more critical and require immediate attention. Pain management can be addressed after ensuring the infant's breathing and oxygen levels are stabilized.

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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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