Which of the following is a safe game for a child with hemophilia?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Child Health Nursing (Pediatrics)

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2016

Explanation

Swimming is a non-contact, low-impact sport, which minimizes the risk of trauma and bleeding in a child with hemophilia.
The buoyancy of water reduces stress on joints, which are particularly vulnerable to bleeding (hemarthrosis) in hemophilia.
Engaging in swimming helps strengthen muscles surrounding the joints, providing better support and stability, which can decrease the frequency of spontaneous bleeds.
Unlike the other options, swimming does not involve running, jumping, or potential collisions with other players or equipment.

Option A: Soccer is a high-contact sport with frequent running, tackling, and risk of falls and collisions, posing a significant danger of bleeds.
Option B: Basketball involves jumping, pivoting, and frequent physical contact with other players, creating a high risk for joint injuries and bleeding.
Option D: Field hockey is an extremely high-risk sport due to the use of hard sticks and a hard ball, combined with running and potential for contact, leading to a high probability of severe injury and bleeding.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Safe physical activities for children with bleeding disorders as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in educating families about lifestyle modifications for chronic conditions like hemophilia. Guiding them on safe physical activities is a key part of holistic care.
Patient education on recognizing signs of a bleed (joint pain, swelling, warmth, limited motion) and initiating immediate RICE therapy is a critical nursing responsibility.
What if the child is on a regular prophylactic factor infusion schedule? While prophylaxis significantly reduces bleeding risk, it does not eliminate it. High-contact sports like soccer and hockey are still generally discouraged. The nurse would reinforce the hematologist's specific recommendations, which may allow for some moderate-risk activities but rarely high-contact ones.

How to Approach the Question

First, identify the core pathophysiology of the condition mentioned in the question. Hemophilia is a bleeding disorder.
Next, determine the primary risk associated with this condition. For hemophilia, the primary risk is uncontrolled bleeding from trauma.
Analyze each option by asking: 'What is the risk of physical trauma, collision, or high impact in this activity?'
Categorize each sport as high-risk (contact, collision) or low-risk (non-contact, low-impact).
Select the option that falls into the low-risk category, as this would be the safest choice for the patient.

Concept Tested & Keywords

Concept Tested: Safe physical activities for children with bleeding disorders
Stem keywords: safe game, child, hemophilia
Lead-in keywords: Which
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 2140-2142, 2139-2141