A nurse is caring for a patient with hemophilia A who has been admitted for bleeding into the knee joint
The prescriber has ordered intravenous factor VIIa (NovoSeven RT). A nursing student wants to know why this patient is not receiving factor VIII. Which statement by the nurse is correct?
a. "Factor VIIa is stronger than factor VIII and will work faster."
b. "Factor VIII is used for prophylaxis, and factor VIIa is used for acute episodes."
c. "Factor VIIa is used when patients develop antibodies against factor VIII."
d. "Factor VIIa provides immune tolerance therapy so that factor VIII will be more effective."
ANS: C
When patients develop antibodies against factor VIII, activated factor VII is used, because it has the same actions as factor VIII. Factor VIIa is not stronger than factor VIII. It is not used for prophylaxis only. Immune tolerance therapy describes the use of repeated administration of factor replacement products to eliminate inhibitor production.
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