The nurse provides home care education to a client newly diagnosed with von Willebrand disease. Which of the following client statements demonstrate correct understanding of the education? Select all that apply.

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Von Willebrand disease is a genetic bleeding disorder caused by a deficiency of von Willebrand factor (vWF), which plays an important role in coagulation. Intranasal desmopressin or topical therapies (eg, thrombin) may be prescribed to stop minor bleeding, whereas major bleeding may require replacement of vWF. Clients should wear medical identification bracelets in case of emergency. Client teaching includes: Notify the health care provider of signs of bleeding (eg, severe joint pain or swelling, headache [especially after injury], blood in urine/stool, uncontrollable nosebleed). Use a humidifier or nasal spray to keep the mucosa moist, reducing the risk of nosebleeds (Option A). Avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). Avoid activities with a higher risk for injury (eg, contact sports) (Option B). Maintain gum integrity (eg, soft-bristled toothbrush, gentle flossing) to minimize bleeding potential (Option C). Report heavy menstrual bleeding (eg, soaking a pad in <3 hours), which can be managed with hormonal therapies and intranasal desmopressin (Option D). (Option E) Clients should avoid medications that can exacerbate bleeding, including aspirin and NSAIDs (eg, ibuprofen, naproxen, ketorolac). Clients should instead use the mnemonic RICE (rest, ice, compression, elevation) to help with pain and inflammation. Educational objective: In von Willebrand disease, a genetic bleeding disorder, deficient von Willebrand factor prevents effective coagulation. Clients can decrease bleeding risk by avoiding high-risk activities (eg, contact sports) and nonsteroidal anti-inflammatory drugs, keeping nasal mucosa moist, and maintaining gum integrity (eg, soft-bristled toothbrush).

The Nurse Provides Home Care Education to a Client Newly