The nurse receives 4 prescriptions for a child diagnosed with hemophilia A who was brought to the emergency department following an injury on the school playground. The child has vomited once and has a headache. Which prescription should the nurse carry out first?

Question

Quizplus · Accepted Answer

Hemophilia is a bleeding disorder caused by a deficiency in coagulation proteins. Treatment consists of replacing the missing clotting factor and teaching the client about injury prevention. Clients with hemophilia who are injured should be monitored closely for bleeding (eg, intracranial bleeds, bleeding into joints). Signs of an intracranial bleed include lethargy, headache, irritability, and vomiting. An intracranial bleed is lethal if unchecked, so administration of factor VIII to a client with hemophilia A is the first order of action, followed by a CT scan. (Option B) Ondansetron (Zofran) can be given to treat nausea/vomiting, but administration of factor VIII is the priority. (Option C) Laboratory studies, particularly hemoglobin and hematocrit levels, are necessary, but the priority is to administer factor VIII. (Option D) A CT scan should be performed for diagnostic purposes, but the bleeding must be stopped emergently. Even if bleeding is evident on CT scan and the client is taken to the operating room, surgery cannot be performed without simultaneous factor VIII replacement. Educational objective: A client with hemophilia A and a head injury is at risk for intracranial bleeding (which sometimes occurs spontaneously). When intracranial or another form of bleeding is suspected, administration of factor VIII is a priority as the client's body cannot form a clot without it.

The Nurse Receives 4 Prescriptions for a Child Diagnosed with Hemophilia