Author Question: During health history assessment, an adult client says, I've been told I have some sort of bleeding ... (Read 26 times)

joblessjake · **on:** Jul 23, 2018

During health history assessment, an adult client says, I've been told I have some sort of bleeding disorder, but I'm not certain. Which responses by the nurse are the most appropriate?

Standard Text: Select all that apply.
1. Did the health care provider mention von Willebrand disease?
2. None of the inherited bleeding disorders affect women.
3. Is there a history of bleeding disorders in your family?
4. Have you ever experienced excessive bleeding or easy bruising?
5. If you had a true bleeding disorder you would have had symptoms earlier in your life.

Question 2

A client who has hemophilia A is scheduled for a minor surgical procedure. The client states, I'm worried about this surgery. My doctor told me I had to come to the hospital for some kind of treatment a week before it. What is that all about?

Which responses by the nurse is the most appropriate?
Standard Text: Select all that apply.
1. You must have misunderstood the directions. Let me check with the health care provider.
2. Blood will be taken and banked in case you need to have it retransfused on the day of surgery.
3. You will be given a test dose of a medication used to increase your clotting factors.
4. This visit is related to your hemophilia and keeping you safe during the surgery.
5. Don't be worried about the testing. Nothing will hurt.

joneynes · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 1,3,4
Rationale 1: Von Willebrand disease is the most common inherited coagulation disorder.
Rationale 2: Von Willebrand disease affects males and females equally.
Rationale 3: Many bleeding disorders are inherited.
Rationale 4: Excessive bleeding and easy bruising are signs of bleeding disorders.
Rationale 5: Von Willebrand disease has both mild and severe forms. Symptoms may have been so mild as to be unnoticed by the client.
Global Rationale: Von Willebrand disease is the most common inherited coagulation disorder. Many bleeding disorders are inherited. Excessive bleeding and easy bruising are signs of bleeding disorders. Von Willebrand disease affects males and females equally. Von Willebrand disease has both mild and severe forms. Symptoms may have been so mild as to be unnoticed by the client.

Answer to Question 2

Correct Answer: 3,4
Rationale 1: The client has not misunderstood the directions provided by the health care provider.
Rationale 2: Preparation for auto-transfusion is not the purpose of this visit.
Rationale 3: Desmopressin therapy can cause an increase in Factor VIII levels. A test dose is given one week prior to minor surgery to determine if the client is responsive to the drug.
Rationale 4: Simple answers that assure the client that his or her safety is being protected are useful when working with clients whose anxiety is elevated.
Rationale 5: The nurse has not answered the client's concerns.
Global Rationale: Desmopressin therapy can cause an increase in Factor VIII levels. A test dose is given one week prior to minor surgery to determine if the client is responsive to the drug. Simple answers that assure the client that his or her safety is being protected are useful when working with clients whose anxiety is elevated. The client has not misunderstood the directions provided by the health care provider. Preparation for auto-transfusion is not the purpose of this visit. The nurse has not answered the client's concerns by dismissing the concerns.