A nurse is teaching a client with newly diagnosed hemophilia about home care practices. What statements by the client indicate that teaching has been effective? Select all that apply.
“I will use a soft toothbrush to decrease bleeding from my gums.”.
“If I get a headache, I will take ibuprofen instead of aspirin.”.
“I will report excessive bleeding to my provider and use precautions to protect my head and joints.”.
“I need clotting factor treatments for the rest of my life if a bleed occurs.”.
“I may experience warm, painful joints and should apply heat if that occurs.”.
Correct Answer : A,C
Choice A is correct because using a soft toothbrush can decrease the risk of bleeding from the gums, which is a common site of bleeding for people with hemophilia.
Choice C is correct because reporting excessive bleeding to the provider and using precautions to protect the head and joints are important aspects of home care for hemophilia.
Choice B is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can interfere with platelet function and increase bleeding tendency. People with hemophilia should avoid NSAIDs and use acetaminophen instead for pain relief.
Choice D is wrong because clotting factor treatments are not only needed when a bleed occurs but also as a preventive measure to reduce the frequency and severity of bleeding episodes. People with severe hemophilia need regular clotting factor replacement therapy for the rest of their lives.
Choice E is wrong because warm, painful joints are signs of joint bleeding, which is a serious complication of hemophilia that can lead to permanent joint damage.
People with hemophilia should not apply heat to their joints, but rather use ice packs, compression, elevation and rest to reduce swelling and pain. They should also seek medical attention and receive clotting factor replacement therapy as soon as possible.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Face the client while speaking and ask them to verify understanding. This intervention would help the client to read the nurse’s lips and confirm the message.
It would also show respect and empathy for the client’s condition.
Choice A is wrong because using exaggerated mouth and hand movements when speaking can be distracting and insulting to the client.
It can also distort the words and make them harder to understand.
Choice C is wrong because standing in front of a light when speaking to the client can create glare and make it difficult for the client to see the nurse’s face.
Touching the client to be sure they know where you are can be startling and unnecessary if the client is not visually impaired.
Choice D is wrong because obtaining an interpreter for sign language is inappropriate unless the client knows sign language.
Not all hearing-impaired clients use sign language, and some may prefer other methods of communication.
Correct Answer is C
Explanation
This is because spinach and salads contain a lot of vitamin K, which can make warfarin less effective at preventing blood clots.
Vitamin K helps the blood to clot, so eating foods high in vitamin K can counteract the effect of warfarin.
Choice A is wrong because wheat bread and butter do not contain a lot of vitamin K and do not affect warfarin.
Choice B is wrong because mangoes and tomatoes do not contain a lot of vitamin K and do not affect warfarin.
Choice D is wrong because aged cheeses and wine do not contain a lot of vitamin K and do not affect warfarin.
It is important to keep a stable diet while taking warfarin and avoid sudden changes in the amount of vitamin K intake. Foods that are high in vitamin K include green leafy vegetables, chickpeas, liver, egg yolks, avocado, and olive oil.
These foods should be limited but not eliminated from the diet. Do not drink cranberry or grapefruit juice while taking warfarin as they can increase the risk of bleeding.
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