(Select all that apply):
A nurse is providing education to a patient with hemophilia about self-care measures.
Which recommendations should the nurse include? (Select all that apply.)

Choice A rationale:

The nurse should recommend avoiding invasive procedures and injections for a patient with hemophilia.

Hemophilia is a bleeding disorder characterized by a deficiency in clotting factors, and any invasive procedures or injections can lead to bleeding episodes.

This recommendation is essential to prevent unnecessary bleeding and complications.

Choice B rationale:

The use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief is not a suitable recommendation for a patient with hemophilia.

NSAIDs can increase the risk of bleeding due to their antiplatelet effects.

It is crucial to avoid medications that can worsen bleeding in individuals with hemophilia.

Choice C rationale:

Engaging in gentle exercise to maintain joint function is a valuable recommendation for patients with hemophilia.

Hemophilia often leads to joint problems due to repeated bleeding episodes, and gentle exercise can help maintain joint mobility and prevent contractures.

It is essential to recommend exercise within the patient's tolerance to promote joint health.

Choice D rationale:

Monitoring for signs of anemia and thrombosis is important for patients with hemophilia.

Anemia can occur if there is excessive bleeding, leading to a decrease in red blood cell count.

Additionally, patients with hemophilia are at risk of developing thrombosis due to treatment with clotting factor concentrates.

Therefore, regular monitoring for these complications is necessary to ensure timely intervention if needed.

Choice E rationale:

Applying heat to bleeding joints to alleviate pain is not a recommended practice for patients with hemophilia.

Heat can increase blood flow to the affected area, potentially exacerbating bleeding.

Cold therapy, such as ice packs, is often recommended to reduce inflammation and pain while minimizing the risk of bleeding.

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.