A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take?

Select all that apply.

Assess for changes in level of consciousness.

Administer factor VIII.

Perform passive range of motion hourly.

Administer factor IX.

Apply a warming blanket over the child.

Answer and Explanation

Correct Answer : A,B

A. Assess for changes in level of consciousness. Abdominal trauma can lead to internal bleeding, which might increase intracranial pressure if bleeding occurs in the brain. Monitoring for neurological changes is essential.
B. Administer factor VIII. Hemophilia A results from factor VIII deficiency, and replacing it prevents further bleeding.
C. Perform passive range of motion hourly. Movement may exacerbate bleeding into the joints or injured tissues. Rest is essential during acute bleeding episodes.
D. Administer factor IX. Factor IX is used for hemophilia B, not hemophilia A.
E. Apply a warming blanket over the child. Hypothermia management may be necessary in some trauma cases, but there is no indication it is needed here based on the scenario provided.

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Correct Answer is A

Explanation

A. Establish a reward system for the child. Positive reinforcement encourages desired behaviors and helps manage challenging behaviors.
B. Limit parent visits with the child. Parental presence is comforting for children with autism and helps maintain their routine.
C. Keep the door to the child's room open. A calm and controlled environment is essential; an open door can increase stimuli.
D. Leave a television on during the night. Excess noise or stimuli, especially during rest periods, can increase anxiety in children with autism.

A. Apply a transparent dressing to the site after the venipuncture. B. Apply a cold compress to the site prior to obtaining the sample. C. Perform an Allen test prior to obtaining the blood sample. D. Obtain the sample using venipuncture.

Correct Answer is D

Explanation

A. Apply a transparent dressing to the site after the venipuncture. A pressure dressing is more appropriate to control bleeding in a child with hemophilia.
B. Apply a cold compress to the site prior to obtaining the sample. Cold compresses reduce swelling but are not required prior to venipuncture.
C. Perform an Allen test prior to obtaining the blood sample. An Allen test is used to evaluate arterial circulation before arterial blood sampling, not for venipuncture.
D. Obtain the sample using venipuncture. Venipuncture is preferred over heel sticks or finger pricks for children with hemophilia because it minimizes trauma and bleeding.

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A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take? Select all that apply.

Nursing Test Bank

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Correct Answer is A

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A nurse is preparing to obtain a blood sample for an Hgb from a child who has hemophilia. Which of the following actions should the nurse plan to take?

Correct Answer is D

Explanation

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A nurse in the emergency department is caring for a preschool-age child who has hemophilia A and sustained an abdominal trauma following a motor vehicle crash. Which of the following actions should the nurse take?

Select all that apply.