(^188) Medical-Surgical Nursing Demystified
PROGNOSIS
The most common sites of bleeding are into the joints, muscles, or from the GI
tract. Mild forms of the disease will only cause bleeding after surgery or trauma,
whereas severe forms of the disease will cause bleeding without any prior cause.
HALLMARK SIGNS AND SYMPTOMS
- Tender joints due to bleeding
- Swelling of knees, ankles, hips, and elbows due to bleeding
- Blood in stool (tarry stool) due to GI blood loss
- Blood in the urine (hematuria)
INTERPRETING TEST RESULTS
- PTT prolonged.
- PT normal.
- Bleeding time normal.
- Fibrinogen level normal.
- Decrease in clotting factor VIII found in blood serum in Hemophilia A.
- Decrease in clotting factor IX found in blood serum in Hemophilia B.
TREATMENT
- Avoid aspirin.
- For hemophilia A administer factor VIII concentrates.
- Cryoprecipitate.
- DDAVP for patients with mild deficiency.
- For hemophilia B administer factor IX concentrates.
NURSING DIAGNOSES
- Acute pain
- Impaired gas exchange