NORCET 3 - 2022 (Shif…: A Toddler with haemophilia admitted in the hospital. Which of the following nursing intervention would be con…

NORCET 3 - 2022 (Shift-2)

Child Health Nursing (Pediatrics)

Hard

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

Explanation

The question asks for the action that is NOT contraindicated, meaning the one safe intervention for a toddler with haemophilia.
Using an electric razor is the recommended method for shaving in patients with bleeding disorders because it minimizes the risk of nicks and cuts to the skin, thereby preventing a bleeding episode.
Unlike blade razors, which scrape directly against the skin, electric razors cut hair above the skin level, making them a much safer option.

Option A: Inserting a thermometer into the rectum can easily tear the delicate and highly vascular mucosal lining, leading to significant and difficult-to-control bleeding in a patient with a clotting disorder.
Option C: Flossing and using a standard toothbrush can easily cause the gums to bleed. While oral hygiene is important, a very soft-bristled toothbrush should be used gently, and flossing is typically contraindicated to prevent gingival haemorrhage.
Option D: Aspirin is an antiplatelet medication that inhibits blood clotting. Administering it to a patient with haemophilia would severely increase the risk of spontaneous or prolonged bleeding and is strictly contraindicated.

Clinical Relevance

Nursing practice connection: Use the key finding related to Safety precautions and contraindicated nursing interventions for a patient with haemophilia to guide bedside assessment, documentation, and the next nursing action.
Preventing injury and bleeding is the cornerstone of nursing care for patients with haemophilia. Every intervention, from taking a temperature to administering medication, must be assessed for bleeding risk.
A nurse's vigilance in implementing these precautions directly impacts patient safety and prevents life-threatening haemorrhages and long-term joint damage (arthropathy).
What if? If the patient had a nosebleed (epistaxis), the nurse's first action would be to have the child sit up and lean forward, pinching the soft part of the nose firmly for 10-15 minutes, rather than tilting the head back.

How to Approach the Question

First, identify the key patient information: 'Toddler with haemophilia'. This immediately signals a high risk for bleeding.
Next, decode the question's phrasing: 'contraindicated, except'. This is a double negative, meaning you are looking for the one action that is PERMITTED or SAFE.
Evaluate each option based on its potential to cause bleeding.
Option A (rectal temp): High risk of mucosal tear and bleeding. Unsafe.
Option B (electric razor): Low risk of skin cuts. Safe.
Option C (flossing): High risk of gum bleeding. Unsafe.

Concept Tested & Keywords

Concept Tested: Safety precautions and contraindicated nursing interventions for a patient with haemophilia.
Stem keywords: Toddler, haemophilia, nursing intervention, contraindicated
Lead-in keywords: except
Clinical cues: The patient is a toddler, a developmental stage associated with frequent falls and injuries, heightening the need for bleeding precautions.
Negative lead-in flag: This question uses negative framing ('contraindicated, except'), which reverses the logic. You are looking for the one SAFE action among the dangerous ones.

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E6 Nursing Brunner Adult Health 3SA Vol 1 Part 3 pp. 158-159, 152-154

E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 196-198