The nurse planning teaching for the parents of a child newly diagnosed with hemophilia

will include information about which long-term complication?

1. Heart valve injury [33%]

2. Intellectual disability [3%]

3. Joint destruction [54%]

4. Recurrent pneumonia [8%]

Explanation: Hemophilia is a bleeding disorder caused by a deficiency in coagulation

proteins. Clients with classic hemophilia, or hemophilia A, lack factor VIII. Clients with

hemophilia B (Christmas disease) lack factor IX. When injured, clients with hemophilia

should be monitored closely for external as well as internal bleeding. The most frequent

sites of bleeding are the joints (80%), especially the knee. Hemarthrosis can occur with

minimal or no trauma, with episodes beginning during toddlerhood when the child is active

and ambulatory. Over time, chronic swelling and deformity can occur.

(Option 1) Heart valve injury is common with rheumatic heart disease not hemophilia.

(Option 2) Intellectual disability in children is commonly seen with fetal alcohol syndrome,

Down syndrome, hypothyroidism, and lead poisoning. In rare cases, hemophilia can cause

life-threatening intracranial bleeding. However, isolated intellectual disability is not seen.

(Option 4) Recurrent pneumonia is commonly seen with cystic fibrosis not hemophilia.

Educational objective:

Clients with hemophilia are at risk for permanent joint destruction due to frequent bleeds

into the joint spaces. Assisting clients with decreasing the incidence of bleeding episodes

and prompt treatment when bleeding occurs can help minimize joint destruction.