A patient with hemophilia presents with joint bleeding (hemarthrosis). What is the priority nursing intervent… - NORCERT 8 Mains-2025

NORCERT 8 Mains-2025

Medical & Surgical Nursing

Medium

Appeared in: NORCERT 8 Mains-2025

Explanation

The core problem in hemophilia A is the deficiency of clotting Factor VIII, which prevents effective blood clot formation.
Administering Factor VIII concentrate is the definitive treatment to replace the missing factor, stop the hemorrhage, and prevent long-term joint damage.
This intervention directly addresses the pathophysiology of the acute bleeding episode, making it the highest priority.
Prompt factor replacement is crucial to minimize pain, swelling, and the risk of chronic hemophilic arthropathy.

Option B: Encouraging range of motion during an acute bleed will worsen the hemorrhage and can lead to increased pain and joint damage.
Option C: While monitoring fluid balance is a general nursing responsibility, it is not the priority action for a localized joint bleed. The immediate threat is the uncontrolled hemorrhage and potential joint destruction.
Option D: Applying warm compresses causes vasodilation, which increases blood flow and will exacerbate the bleeding into the joint.

Visual 1: Infographic - A diagram illustrating the RICE (Rest, Ice, Compression, Elevation) protocol plus Factor replacement for managing acute hemarthrosis.
Visual 2: Pathophysiology Flowchart - A flowchart showing how Factor VIII deficiency leads to impaired clotting and results in hemarthrosis.
Visual 3: Anatomical Diagram - An illustration comparing a healthy joint with a joint affected by acute and chronic hemarthrosis, showing synovial hypertrophy and cartilage erosion.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Priority nursing intervention for hemarthrosis in hemophilia in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A nurse's primary role in an acute hemarthrosis episode is the prompt administration of the prescribed clotting factor concentrate. Delays can lead to irreversible joint damage.
Patient and family education is critical. They must be taught to recognize the earliest signs of a bleed (e.g., tingling, warmth, pain before swelling) and to initiate factor replacement at home if part of their treatment plan.
Nurses must educate patients to avoid medications that impair platelet function, such as aspirin and NSAIDs, as they can increase bleeding risk.

How to Approach the Question

First, identify the core clinical problem: an acute bleed (hemarthrosis) in a patient with a known clotting disorder (hemophilia).
Next, analyze the question's requirement, which is to identify the 'priority' nursing intervention. This means you must find the action that addresses the most immediate life- or limb-threatening issue.
Evaluate each option based on the pathophysiology. Hemophilia is a lack of clotting factor. The only way to stop the bleed is to replace that factor.
Consider the consequences of each action. Administering factor stops the bleed. Encouraging movement or applying heat makes it worse. Monitoring fluids is passive and doesn't solve the immediate problem.
Select the option that directly corrects the underlying cause of the acute problem. In this case, administering Factor VIII is the direct and most crucial treatment.

Concept Tested & Keywords

Concept Tested: Priority nursing intervention for hemarthrosis in hemophilia
Stem keywords: hemophilia, joint bleeding, hemarthrosis, priority nursing intervention
Lead-in keywords: priority
Clinical cues: Patient with hemophilia
Clinical cues: Presents with joint bleeding (hemarthrosis)

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