52. The pediatrician assesses a child with an acute episode of hemophilia that involves the lower extremities Which pediatrician's order should a nurse question?
52. The pediatrician assesses a child with an acute episode of hemophilia that involves the lower extremities Which pediatrician's order should a nurse question?
. Active range-of-motion exercises twice daily.
. Passive range-of-motion exercises twice daily.
. May use wrist splints at night.
. May use ankle splints at night.
Test-Taking Tip
Look for what should not be ordered. Think active (i.e., the child does it) rather than passive (i.e., done by physical therapist) and what the consequences of each activity could be.
Content Area: Child Health, Hematological; Integrated Process: Nursing Process, Evaluation; Cognitive Level: Application; Client Need/Subneed: Safe and Effective Care Environment/Safety and Infection Control/Error Prevention
.
Answer 1 is incorrect because active range-of-motion exercises are best so that the child can gauge his or her own pain tolerance. Answer 2 is correct because passive range-of-motion exercises should never be part of an exercise regimen after an acute episode of hemophilia because the joint capsule could easily be stretched and bleeding could recur. Answer 3 is incorrect because there is no contraindication to using wrist splints at night since the child may have sustained previous injuries to, or previous bleeds in, this area of the body. The splints assist in maintaining mobility and provide comfort when the wrists are not in use while asleep at night. Answer 4 is incorrect because there is no contraindication to using ankle splints at night since the child may have sustained previous injuries to, or previous bleeds in, this area of the body. The splints assist in maintaining mobility and provide comfort when the ankles are not in use while asleep at night.