A Toddler with haemophilia admitted in the hospital. Which of the following nursing intervention would be contraindicated, except?

Appeared in: NORCET 3 - 2022 (Shift-2)

Explanation

The core principle in caring for a patient with haemophilia is the prevention of bleeding.
Using an electric razor is the standard recommended practice for shaving because it is designed to cut hair without cutting the skin, thereby preventing nicks and bleeding.
This intervention directly aligns with the goal of minimizing trauma and bleeding risk in a patient with a severe clotting disorder.

Option A: Obtaining a rectal temperature is incorrect because it is an invasive procedure that can easily cause trauma to the rectal mucosa, leading to significant and hard-to-control bleeding.
Option C: This option is incorrect because flossing and using a standard toothbrush can easily cause gingival (gum) bleeding, which can be prolonged in a patient with haemophilia.
Option D: Administering aspirin is incorrect because it is an antiplatelet agent that impairs the body's ability to form a clot, thereby increasing the risk of spontaneous bleeding.

Visual 1: Infographic: A 'Do's and Don'ts' chart for a child with haemophilia, visually contrasting safe activities (electric razor, soft toys) with unsafe ones (blade razor, contact sports, aspirin).

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing care and safety precautions for a pediatric patient with haemophilia to guide bedside assessment, documentation, and the next nursing action.
Patient safety is the paramount concern. A nurse's primary role is to protect patients with haemophilia from injury and prevent bleeding episodes through meticulous care and education.
Nurses must educate the patient and family on all aspects of haemophilia care, including activity restrictions, proper oral hygiene, medication safety, and recognizing signs of bleeding.
What if the patient was an adult male needing to shave? The principle remains the same. An electric razor is the only safe option. This highlights that these safety precautions are lifelong.

How to Approach the Question

First, decode the question's phrasing. 'Contraindicated, except' is a double negative that means 'What is allowed?' or 'What is the one safe action?'.
Next, recall the pathophysiology of haemophilia: it is a bleeding disorder due to a lack of clotting factors.
The guiding principle for all interventions must be: 'Does this action increase the risk of bleeding?'.
Evaluate each option against this principle:
Rectal temperature: Invasive, high risk of mucosal bleeding. Eliminate.
Electric razor: Non-invasive to the skin, low risk of bleeding. Keep as a possibility.

Concept Tested & Keywords

Concept Tested: Nursing care and safety precautions for a pediatric patient with haemophilia.
Stem keywords: Toddler, haemophilia, nursing intervention
Lead-in keywords: contraindicated, except
Clinical cues: Patient is a toddler, which increases the risk of injury from falls and requires specific safety considerations.
Clinical cues: Diagnosis is haemophilia, a critical bleeding disorder.

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