Author Question: A child with hemophilia A who weighs 30 kg receives factor VIII on an ongoing basis as prophylaxis. ... (Read 33 times)

washai · **on:** Jul 23, 2018

A child with hemophilia A who weighs 30 kg receives factor VIII on an ongoing basis as prophylaxis. The provider orders desmopressin (Stimate) to be used for nosebleeds.

The nurse will instruct the child's parents to give the medication as _____ nostril as needed.
a. 1 spray in each
b. 1 spray in one
c. 2 sprays in each
d. 2 sprays in one

Question 2

A patient with hemophilia is hospitalized for infusion of factor VIII replacement through a venous port. While giving the drug, the nurse notes that the patient's temperature is 101.5 F. The nurse will contact the provider to report which possibility?

a. Anaphylactic reaction
b. Contamination of factor replacement
c. Port infection
d. Thrombolytic event

princessflame2016 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Children who weigh less than 50 kg should use 1 spray in one nostril for a dose of 150 mcg. Each spray delivers 150 mcg, so 1 spray in both nostrils would give a dose of 300 mcg. Using 2 sprays in one nostril would give a dose of 300 mcg; using 2 sprays in both nostrils would give a dose of 600 mcg.

Answer to Question 2

ANS: C
Central venous access devices are used to facilitate frequent IV administration of factor replacement but pose the risks of infection and thrombosis. This patient has a fever, which is a symptom of infection. Anaphylactic reactions to factor replacement can occur but are characterized by wheezing and shortness of breath, along with swelling in the face. Viral contamination of factor replacement is rare with factor VIII. Thrombolytic events would have symptoms associated with clot formation in certain organs and are not associated with fever.