Nursing Intervention
Maintain protective environment to prevent injury to client.
Monitor closely for signs of bleeding.
Treat bleeding episodes promptly.
Apply pressure to nares if nosebleed is noted.
Minimize crippling due to contractures and joint damage from
bleeding:- Promote complete absorption of blood from joints.
- Mild exercise of limbs during confinement to prevent disuse.
- Encourage regular exercise regimen at home.
Client and Family Teaching
Protective care to prevent injury: Child-proof rooms with rounded
corners, padding, and so on, to minimize injury to mobile infant or
toddler.
Noncontact sports and activities with minimum injury potential such as
golf, swimming.
Safety equipment to minimize injury.
Soft toothbrush with water irrigation for mouth care to prevent oral
bleeding.
Electric razor instead of blades for shaving.
Teach to recognize bleeding episode in early stages and early treatment:- RICE (rest, ice, compression, and elevation) to control bleeding
Medical identification bracelet and notification of school nurse regard-
ing condition.
Teach child to control condition and lifestyle needed to avoid episodes
and promote maximum development.
Refer as needed for financial support if insurance ceases to cover client
when older than age 21 and is removed from parental insurance.
Provide support for emotional stress to patient and family related to
chronic condition.
Genetic counseling: - Encourage testing of siblings to allow for childbearing planning.
- Explain that each pregnancy when both parents are carriers presents
a 25% chance a child will be born with the disease and a 50% chance
the child will have the sickle cell trait. - Refer for counseling and family planning if additional childbearing
is desired. - Discuss alternative parenting options (insemination, adoption, etc.).
Nursing alert Avoid aspirin compounds and substitute acetaminophen because
aspirin impairs platelet function.5(^138) Pediatric Nursing Demystified