The nurse is assessing an adolescent child with the diagnosis of hemophilia. In which part of the body would the nurse expect bleeding to occur?

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.

A. Metabolic alkalosis is not a common acid-base imbalance associated with ARF. Instead, metabolic acidosis is more commonly observed due to the retention of metabolic waste products.

B. Water and sodium (Na) retention: In ARF, the kidneys are unable to effectively filter and excrete waste products and excess fluids. This leads to the retention of water and sodium, contributing to fluid overload.

C. Anemia: ARF can lead to decreased erythropoietin production by the kidneys, which can result in anemia due to reduced red blood cell production.

D. Hyperkalemia: The impaired kidney function in ARF may result in the inability to regulate potassium levels. Elevated levels of potassium (hyperkalemia) can be a dangerous complication.

E. Increased urinary output is not a typical finding in ARF. Instead, the hallmark of ARF is a reduction in urine output or oliguria.