Last year, I provided nursing care for a ten-year-old boy with hemophilia. It is a disease related to hereditary coagulopathy transmitted by a recessive type linked to sex, in particular, the X chromosome. Hemophilia is characterized by awkwardly stopping bleeding due to a deficiency in the activity of VIII, IX, or XI plasma factors of the blood coagulation system. My patient was ill with hemophilia type B, which is accompanied by a violation of blood clotting due to a lack of factor IX. According to Burchum and Rosenthal (2021), normal hemostasis requires > 30% of normal factor IX levels, while my patient had a level of < 5%. As a result of an injury, the child developed hemarthrosis of the knee joint.
I provided specialized nursing care to the child, which included pain relief, support for optimal physical mobility, reduced risk of bleeding and further injury, and psychological support. To relieve the pain, the knee joint was immobilized, and an elastic bandage and an ice pack were applied. The child was administered Tylenol orally and factor IX intravenously, as indicated by the attending physician. Hockenberry et al. (2021) note that intramuscular and subcutaneous injections should not be given in hemophilia. Light, passive physical exercises were provided when the child’s condition stabilized. I also taught the boy preventive measures, such as using protective equipment, to avoid future injuries. I also monitored partial thromboplastin time, factor IX coagulation tests, and hemoglobin and hematocrit levels to reduce the risk of bleeding. To reduce the number of new injuries from the ward, I removed all sharp objects, and the sharp edges of the furniture were equipped with foam rubber. A key aspect of my patient care was the provision of psychological support. I constantly inspired him that he was mentally and physically healthy and introduced him to peers who were in the department and had similar diseases.
References
Burchum, J. R. & Rosenthal, L. (2021). Lehne’s pharmacology for nursing care (11th ed.). Elsevier Health Sciences
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2021). Wong’s essentials of pediatric nursing (11th ed.). Elsevier Health Sciences.