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RN Nursing · Hematological Disorders in Children · Practice question

A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?

Answer & explanation

Correct: If bleeding occurs, apply pressure, ice, elevate, and rest the extremity.

Hemophilia A is an X-linked recessive bleeding disorder caused by deficiency of clotting factor VIII. Home care education for families must focus on bleeding management and injury prevention. When bleeding occurs, the correct first-aid response is to apply pressure, apply ice, elevate the affected extremity, and rest it — the RICE principle adapted for hemophilia. Pressure reduces blood flow to the site, ice causes vasoconstriction, elevation uses gravity to decrease perfusion pressure, and rest prevents further trauma. This is the appropriate initial home response while factor replacement is being arranged. Using a firm, dry toothbrush is incorrect; children with hemophilia should use a soft-bristled toothbrush to minimize gingival bleeding and trauma to oral mucosa. Aspirin — even in low doses — is absolutely contraindicated in hemophilia because it irreversibly inhibits platelet aggregation through thromboxane A2 inhibition, significantly worsening bleeding risk; it is also contraindicated in children under 12 due to Reye's syndrome risk. Restricting interactive play with other children is not appropriate; while contact sports with high injury risk should be avoided, normal social development and age-appropriate activity should be encouraged. Overprotecting the child can harm psychological development. The family should instead focus on safe play environments and wearing protective equipment.

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