Planning and implementation of nursing care - haemophilia, Biology

Planning of Nursing Care

  1. Prevent and control  bleeding.
  2. Administer replacement therapy of factor VIII and IX as advised. 
  3. Educate and support the patient and family. 

Implementation of Nursing Care 

Prevent and Control Bleeding 

You as a nurse have to provide a safe and soothing environment  to  the child. The finger nails should be kept  short to  avoid scratching. Avoid using diaper pins (in infants) or use with caution. Provide soft  toys without sharp comers. Soft tooth brushes should be used to clean teeth and child should be given soft foods.Child  should not be unnecessarily restricted and should be given freedom but contact sports should be avoided. Bleeding  from open wounds  should be controlled by pressure bandage, cold compresses, and local use of  thrombin, gelatin foam or  fibrin. As far as possible cautery  and suturing of wounds should be avoided. 

Replacement  Therapy 

Fresh blood 15-20 ml/kg within  six hours of collection  should be used. Antihaemophilic globulin factor VIlI and IX  available  in the form of cryoprecipitate made from fresh plasma is also used in dosage of 100-  150 units kg/24 hours. It is your duty to administer  or assist in  administering fresh blood, plasma or  cryoprecipitate,  promptly and sufficiently  to achieve and maintain a haemostatic level of  factor VIII between 20 to 25per cent and watch for any untowerd reaction. 

Provide Education and Support 

After haemophilia is diagnosed  in the child and when the parent learn about it they feel , depressed and somewhat guilty about this disease. Parent education regarding  the disease can help them provide normal life  to  their affected child. This will help  them  to minimise  the  effect of disease on growth and development  of the child. Your education will help  them to relieve depression. Tell the parents to  give the child same guidance as a normal child. 

The parents and child are  taught  to  identify the signs of bleeding  and how to carry out their transfusion procedure. This prevents repeated hospitalisation  and promotes  their involvement  in the  self care of child. 

When child is prone  to  spontaneous bleeding replacement factor is given prophylactically. Parents  and child are educated and informed about cummunity support and resources for such diseases. Genetic counselling  is given for child bearing  families.  

Posted Date: 10/27/2012 1:05:29 AM | Location : United States







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