The nurse is teaching the family of a child, age 8 years, with ...

[@Brianna17]

The nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. What should the nurse tell the family to do to minimize joint injury?
 
  a. Administer nonsteroidal anti-inflammatory drugs (NSAIDs).
  b. Administer DDAVP (synthetic vasopressin).
  c. Provide intravenous (IV) infusion of factor VIII concentrates.
  d. Encourage elevation and application of ice to the involved joint.

Question 2

In which condition are all the formed elements of the blood simultaneously depressed?
 
  a. Aplastic anemia
  b. Sickle cell anemia
  c. Thalassemia major
  d. Iron deficiency anemia

[k.lashomb]

Answer to Question 1

ANS: C
Parents are taught home infusion of factor VIII concentrate. For moderate and severe hemophilia, prompt IV administration is essential to prevent joint injury. NSAIDs are effective for pain relief. They must be given with caution because they inhibit platelet aggregation. A factor VIII level of 30 is necessary to stop bleeding. DDAVP can raise the factor VIII level fourfold. Moderate hemophilia is defined by a factor VIII activity of 4.9. A fourfold increase would not meet the 30 level. Ice and elevation are important adjunctive therapy, but factor VIII is necessary.

Answer to Question 2

ANS: A
Aplastic anemia refers to a bone marrow failure condition in which the formed elements of the blood are simultaneously depressed. Sickle cell anemia is a hemoglobinopathy in which normal adult hemoglobin is partly or completely replaced by abnormal sickled hemoglobin. Thalassemia major is a group of blood disorders characterized by deficiency in the production rate of specific hemoglobin chains. Iron-deficiency anemia results in a decreased amount of circulating red cells.