A child with moderate hemophilia A who weighs 20 kg is admitted ...

[cherise1989]

A child with moderate hemophilia A who weighs 20 kg is admitted to the hospital after a knee injury with bleeding into the joint. The nurse will expect the provider to order which medication?
 
  a. Advate 400 units IV over 10 minutes
  b. Benefix 800 units slow IV push
  c. Desmopressin 6 mcg IV over 15 to 30 minutes
  d. Tranexamic acid (Cyklokapron) 200 mg IV

Question 2

A patient with epistaxis and a history of hemophilia A is admitted to the unit and is scheduled for replacement therapy. The nurse should prepare to administer which medication?
 
  a. Tranexamic acid (Cyklokapron)
  b. Aminocaproic acid (Amicar)
  c. Desmopressin (Stimate)
  d. Factor VIII

[Jossy]

Answer to Question 1

ANS: A
Advate is a third-generation product for factor VIII replacement, which this child needs. Third-generation products are safer, because they are not exposed to BSA or HAS during production; therefore, this is the product of choice. Benefix is a factor IX replacement product and is not indicated for hemophilia A. Desmopressin is used to stop bleeding in patients with mild hemophilia. Tranexamic acid is used as adjunctive therapy.

Answer to Question 2

ANS: D
The cornerstone of treatment for hemophilia A is replacement therapy with factor VIII. Tranexamic acid and aminocaproic acid are antifibrinolytic agents that act primarily by preventing the formation of plasmin from its precursor. Desmopressin promotes the release of factor VIII from the vascular endothelium and has the advantage of being cheaper than factor VIII. Also, it can be administered by nasal spray or by IV infusion. However, repeated use of desmopressin can deplete stored factor VIII.

[cherise1989]

Excellent

[ricroger]

TYSM