الاثنين، 27 أغسطس 2018

195-hemophilia

About
An x-linked genetic bleeding disorder that causes hemorrhages and inability to clot.
Assess
Bleeding, hematomas, joint pain, Decreased hemoglobin and hematocrit, hematuria, GI bleeding
Complications
Bleeding, hemorrhage, transfusion reactions, death.
Diagnosis
  • Risk for injury related to decreased clotting ability.
  • Fluid volume deficit related to major blood loss.
  • Knowledge deficit related to disease process and management
Goals
  • The client will identify activity restrictions and measures to reduce the risk of hemorrhage.
  • The client will demonstrate proper procedures to take if hemorrhage were to occur.
  • The client will identify signs and symptoms that require immediate medical attention.
  • The client will verbalize fears and concerns related to disease process.
Interventions
  • Assess for active bleeding, joint pain, hematuria, GI bleeding, injury.
  • Assess client's current understanding of disease process, treatments, and medications.
  • Monitor CBC and clotting factors.
  • Avoid injections, invasive procedures, NSAIDS, ASA, OTC medications.
  • Administer fluid replacement, factor VIII concentrates, factor IX concentrates, plasma as indicated by physician for an acute bleed.
  • Teach client activity restrictions, signs and symptoms of bleeding, injury prevention strategies.
  • Teach client how to infuse concentrates during an acute hemorrhage.
  • Encourage client to wear a medical alert bracelet.
  • Teach client about disease process, genetic link, treatment.
  • Encourage opportunities for client to express feelings and concerns regarding diagnosis and treatment.
  • Teach client appropriate prophylaxis prior to any invasive procedure to minimize risks of hemorrhage ( administration of blood, plasma, or concentrates).

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