Question

• What is the significance of low Factor V!!! values? (diagnosis and reason behind it)  
• What nursing interventions/ education would you implement for someone with factor VIII hemophilia?
• What orders / treatment would you expect for a pediatric with epistaxis and low Factor VIII counts?

Answer 1

The low Factor V leads to coagulation disorders where there is imbalances in the clotting factor when there is cut pr wound causing severe bleeding. This can simultaneously whe m.h there is deficiency of Factor VIII. It is diagnosed with the following tests

• Factor V assay:there is a deficiency of this factor
• Prothrombin time and Activated partial prothrombin time:This affects the clotting factor .Usually factor 1,2,5,7,8,9,10,11,12 are affected
• BT:the bleeding btime is assessed
• CT: the clotting time after the bleeding is noted to detect abnormalities

Some of the nursing intervention/ education to be implemented for a patient with the factor VIII hemophilia are

• do not prick the patient for any procedure unless indicated and necessary because this can result in bleeding
• Administer pain killers to treat pain
• Provide psychological support to the patient
• Administer factor 8 as per order
• Childrens can be encouraged for more indoor games than outdoor games which has many physical strains
• Assess the patient for internal bleeding (usually manifests with pain, warmth at the site of bleeding,hematuria,malena,vomiting)
• Encouraging to take Emicizumab weekly as per order to prevent bleeding

The treatment expected for a pediatric case with epistaxis and low Factor VIII counts are

• Administration of desmopressin to increase the level of factor VIII
• In case of epistaxis,administer factor 8 via very slow intravenous infusion ,encourage the child not to lean forward because this can block the airway ,mild pinching is allowed,a vasoconstrictor will stop bleeding, gauze packing ,ice application to enhance clotting
• Antifibrinolytics to stop bleeding