A client who has hemophilia A is scheduled for a minor surgical procedure. The client states, "I'm worried about this surgery. My doctor told me I had to come to the hospital for some kind of treatment a week before it. What is that all about?"

Question

Which responses by the nurse is the most appropriate?
Standard Text: Select all that apply.
1. "You must have misunderstood the directions. Let me check with the health care provider."
2. "Blood will be taken and banked in case you need to have it retransfused on the day of surgery."
3. "You will be given a test dose of a medication used to increase your clotting factors."
4. "This visit is related to your hemophilia and keeping you safe during the surgery."
5. "Don't be worried about the testing. Nothing will hurt."

Answer 1

Correct Answer: 3,4
Rationale 1: The client has not misunderstood the directions provided by the health care provider.
Rationale 2: Preparation for auto-transfusion is not the purpose of this visit.
Rationale 3: Desmopressin therapy can cause an increase in Factor VIII levels. A test dose is given one week prior to minor surgery to determine if the client is responsive to the drug.
Rationale 4: Simple answers that assure the client that his or her safety is being protected are useful when working with clients whose anxiety is elevated.
Rationale 5: The nurse has not answered the client's concerns.
Global Rationale: Desmopressin therapy can cause an increase in Factor VIII levels. A test dose is given one week prior to minor surgery to determine if the client is responsive to the drug. Simple answers that assure the client that his or her safety is being protected are useful when working with clients whose anxiety is elevated. The client has not misunderstood the directions provided by the health care provider. Preparation for auto-transfusion is not the purpose of this visit. The nurse has not answered the client's concerns by dismissing the concerns.