A client with hemophilia A asks the nurse about the cause of the condition.
Which response by the nurse is accurate?

Choice A rationale:

Genetic testing for the F8 or F9 gene mutations.

Rationale: Genetic testing for mutations in the F8 (Factor VIII) or F9 (Factor IX) genes is a critical diagnostic evaluation for hemophilia.

Hemophilia A is caused by mutations in the F8 gene, while hemophilia B is caused by mutations in the F9 gene.

Choice B rationale:

Prothrombin time (PT)

Rationale: PT is not typically used to diagnose hemophilia.

It primarily evaluates the extrinsic and common coagulation pathways, which are not directly related to hemophilia, which is a disorder of the intrinsic coagulation pathway.

Choice C rationale:

Partial thromboplastin time (PTT)

Rationale: PTT is one of the key tests used to diagnose hemophilia.

It assesses the intrinsic coagulation pathway, and prolonged PTT results may indicate a bleeding disorder, including hemophilia.

Choice D rationale:

Platelet count.

Rationale: Platelet count is not a specific test for diagnosing hemophilia.

Hemophilia is a deficiency in clotting factors, not a platelet disorder.

Platelet counts are typically normal in individuals with hemophilia.

Choice E rationale:

Fibrinogen levels.

Rationale: Fibrinogen levels are not typically used to diagnose hemophilia.

Hemophilia is characterized by deficiencies in specific clotting factors (Factor VIII or Factor IX), and fibrinogen levels are not directly related to these factors.

Choice A rationale:

"It's just a minor issue, and the pain will go away on its own." This statement is not appropriate because joint pain, swelling, and reduced range of motion in a client with hemophilia, known as hemarthrosis, can lead to long-term joint damage and disability if not properly managed.

Downplaying the issue is not in the best interest of the client and may lead to inadequate care.

Choice B rationale:

"Let's apply ice to the affected joint to reduce the swelling." While applying ice to an inflamed joint can help reduce swelling in some cases, it may not be the best immediate approach for a client with hemophilia.

Ice application should be done with caution, as it can potentially worsen bleeding in individuals with hemophilia.

The primary focus should be on assessing the severity of the bleeding, providing appropriate pain management, and consulting with a healthcare provider.

Choice C rationale:

"I'll assess your joint and provide pain management as needed." This is the most appropriate response.

The nurse should assess the client's joint for signs of hemarthrosis, such as swelling, warmth, and reduced range of motion.

Prompt assessment allows for early intervention to manage the bleeding and alleviate pain.

Providing pain management as needed, which may include analgesic medications, is essential to improve the client's comfort and prevent further complications.

Choice D rationale:

"You should perform strenuous exercises to improve joint mobility." Encouraging strenuous exercises in a client with hemophilia who is already experiencing joint pain and swelling is not advisable.

Strenuous exercise can exacerbate bleeding and joint damage.

Instead, the focus should be on gentle range-of-motion exercises and physical therapy, guided by a healthcare provider, to improve joint mobility without increasing the risk of bleeding.