Planning of Nursing Care 

1. Minimise  trauma  to the child and provide safe environment. 
2. Control bleeding. 
3. Administer drugs. 

Implementation of Nursing Care 

Minimise Trauma to the Child 

Child is protected from injury in the hospital. The craddle and chairs need to be padded, avoid use of hard tooth brushes  and use light mouth washes  or glycerine swabs for cleaning mouth. Avoid using  tight garments and give  smooth edged or soft toys to  the child. Intramuscular nledications  should not be used to prkvent frequent venipunctures. Take care to avoid elective  surgery, sports and infection. Provide good nutritious diet. 

Control Bleeding 

Child is  given blood transfusion with packed red blood cells  to  control severe bleeding. Transhsion of fresh blood or platelet concentrates is avoided as transfused platelets are  short lived and may lead to devlopment  of antibodies to donor platelets. 

Administration of Drugs 

In order to relieve joint pain acetaminophen is used rather than salicylates. Corticosteroids  such as prednislone may be used if haemorrhagic manifestations are severe or if intracranial haemorrhage is suspected. Corticosteroid  therapy helps to shorten the duration and  reduces the severity of  acute phase. Splenectomy  is indicated in case of chronic and recurrent case, and if  the child fails to respond to all other supportive measures.