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Hemophilia Concept Map with Sample Case
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LEGEND:
Pathophysiology
Diagnostic Finding
ManifestationsComplication
ComplicationMedical Management
Nursing Management
Can bleed with bad
Injury (ex. surgery, shots)
Can bleed with bad
Injury (ex. surgery, shots)
Can bleed with bad
Injury (ex. surgery, shots)
Rare Hemarthrosi
s
Impaired physical mobility r/t joint
pain
Plasmapheresis or
concurrent immunosuppressive therapy
Plasmapheresis or
concurrent immunosuppressive therapy
Predisposing Factor:
Age: Toddler age diagnosis
Genetics: X-Linked Disease
Sex: Male
Predisposing Factor:
Age: Toddler age diagnosis
Genetics: X-Linked Disease
Sex: Male
LEGEND:
Pathophysiology
Amniocentesis or
chorionic villus
sampling
Diagnostic Finding
ManifestationsComplication
Amniocentesis or
chorionic villus
sampling
ComplicationMedical Management
Nursing Management
Ineffective protection r/t factor
VIII deficiency
Ineffective protection r/t factor
VIII deficiency
Mild Hemophilia
6%-25% factor level
Mild Hemophilia
6%-25% factor level
Altered comfort: Pain
r/t nerve compression secondary to hemarthrosis
Rare Hemarthrosi
s
Altered comfort: Pain
r/t nerve compression secondary to hemarthrosis
He was given Factor VIII transfusion 250 IU once daily for the
next four days.
Impaired physical mobility r/t joint
pain
He was given Factor VIII transfusion 250 IU once daily for the
next four days.
Plasmapheresis or
concurrent immunosuppressive therapy
Infusion of fresh frozen
plasma (replacement
therapy)
Plasmapheresis or
concurrent immunosuppressive therapy
Activated prothrombin
complex concentrate
s
Infusion of fresh frozen
plasma (replacement
therapy)
Activated prothrombin
complex concentrate
s
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Predisposing Factor:
Age: Toddler age diagnosis
Genetics: X-Linked Disease
Sex: Male
Father
Predisposing Factor:
Age: Toddler age diagnosis
Genetics: X-Linked Disease
Sex: Male
Father
Amniocentesis or
chorionic villus
sampling
Changes in f8 Gene
Amniocentesis or
chorionic villus
sampling
Hemophilia A(Factor VIII)
Changes in f8 Gene
Ineffective protection r/t factor
VIII deficiency
Hemophilia A(Factor VIII)
Ineffective protection r/t factor
VIII deficiency
Mild Hemophilia
6%-25% factor level
Mild Hemophilia
6%-25% factor level Hitting left
elbow to the wall
Altered comfort: Pain
r/t nerve compression secondary to hemarthrosis
Hemarthrosis
Left elbow
decreased ROM
Altered comfort: Pain
r/t nerve compression secondary to hemarthrosis
Pain
Long-term Joint
Damage
Left elbow
decreased ROM
He was given Factor VIII transfusion 250 IU once daily for the
next four days.
CBC
Long-term Joint
Damage
He was given Factor VIII transfusion 250 IU once daily for the
next four days.
ActivatedPartial
Thromboplastin Time (APTT)
Test72.5 sec
(prolonged)
Infusion of fresh frozen
plasma (replacement
therapy)
ActivatedPartial
Thromboplastin Time (APTT)
Test72.5 sec
(prolonged) Activated prothrombin
complex concentrate
s
Infusion of fresh frozen
plasma (replacement
therapy)
Prothrombin Time (PT)
Test9.9 sec
(normal)
Activated prothrombin
complex concentrate
s
Prothrombin Time (PT)
Test9.9 sec
(normal)
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Father
Father
Formation of the Son's
DNA(XhY)
Formation of the Son's
DNA(XhY)
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Changes in f8 Gene
Hemophilia A(Factor VIII)
Changes in f8 Gene
Clotting Factor Test
(Factor Assay)
Hemophilia A(Factor VIII) Clotting
Factor Test
(Factor Assay)
Moderate Hemophilia
1%-5% factor level:2.4%
Moderate Hemophilia
1%-5% factor level:2.4%Hitting left
elbow to the wall
Hemarthrosis
SwellingLeft elbow
decreased ROM
Can bleed with Slight
Injury
Long-term Joint
Damage
SwellingLeft elbow
decreased ROM
Can bleed with Slight
Injury
CBC
Long-term Joint
Damage
Severe Anemia
ActivatedPartial
Thromboplastin Time (APTT)
Test72.5 sec
(prolonged)
Severe Anemia
ActivatedPartial
Thromboplastin Time (APTT)
Test72.5 sec
(prolonged)
Prothrombin Time (PT)
Test9.9 sec
(normal)
Prothrombin Time (PT)
Test9.9 sec
(normal)
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Mother
Mother
Formation of the Son's
DNA(XhY)
Formation of the Son's
DNA(XhY)
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Changes in f9 Gene
Hemophilia B(Factor IX)
Changes in f9 Gene
Clotting Factor Test
(Factor Assay)
Clotting Factor Test
(Factor Assay)
Fibrinogen Test
Moderate Hemophilia
1%-5% factor level:2.4%
Easy bruising
Moderate Hemophilia
1%-5% factor level:2.4%
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
Can bleed with Slight
Injury
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
Pain or paralysis
due to the pressure of hematomas on nerves
Can bleed with Slight
Injury
Pain or paralysis
due to the pressure of hematomas on nerves
Compartment
SyndromeSevere Anemia
Compartment
SyndromeSevere Anemia
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Concept Map on A Patient with Hemophilia
BY: Cabarrubias
NavarroPowers
Mother
Precipitating Factors:
EnvironmentTrauma
Mother
Son's DNA Carries the X-Chromosome
with the disease.
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Son's DNA Carries the X-Chromosome
with the disease.
Spontaneos genetic mutation on DNA Formation
on the X Chromosome
Changes in f9 Gene
*The X-Linked disease will be passed down to
the next generation, the majority carriers
are Female.
Hemophilia B(Factor IX)
Changes in f9 Gene
*The X-Linked disease will be passed down to
the next generation, the majority carriers
are Female.
Easy bruising
Usual Hemarthrosi
s
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
Usual Hemarthrosi
s
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
Internal Bleeding
Cutaneous hematoma formation with minor
trauma (e.g., an injection)
GI bleeding, with
hematemesis (vomiting
blood)
Pain or paralysis
due to the pressure of hematomas on nerves
GI bleeding, with
hematemesis (vomiting
blood)
occult blood in
the stools
Pain or paralysis
due to the pressure of hematomas on nerves
Compartment
Syndrome
occult blood in
the stools
gastric pain, or abdominal
pain
Compartment
Syndrome
gastric pain, or abdominal
pain
Severe Internal Bleeding
Severe Internal Bleeding
Precipitating Factors:
EnvironmentTrauma
Son's DNA Carries the X-Chromosome
with the disease.
Son's DNA Carries the X-Chromosome
with the disease.
*The X-Linked disease will be passed down to
the next generation, the majority carriers
are Female.
*The X-Linked disease will be passed down to
the next generation, the majority carriers
are Female.
Severe Hemophilia
Less than 1% factor level
Severe Hemophilia
Less than 1% factor level
Usual Hemarthrosi
s
Spontaneous hematuria or epistaxis
Usual Hemarthrosi
s
Bleeding from the gums and prolonged bleeding following
minor injuries or
cuts
Spontaneous hematuria or epistaxis
Internal Bleeding
Bleeding from the gums and prolonged bleeding following
minor injuries or
cuts
GI bleeding, with
hematemesis (vomiting
blood)
Bleeding from the gums and prolonged bleeding following
minor injuries or
cuts
GI bleeding, with
hematemesis (vomiting
blood)
occult blood in
the stools
Aminocaproic acid
occult blood in
the stools
gastric pain, or abdominal
pain
gastric pain, or abdominal
pain
Severe Internal Bleeding
Severe Internal Bleeding
Severe Hemophilia
Less than 1% factor level
Severe Hemophilia
Less than 1% factor level
Can bleed even minor injury
Spontaneous hematuria or epistaxis
Bleeding from the gums and prolonged bleeding following
minor injuries or
cuts
Spontaneous hematuria or epistaxis
Desmopressin
Bleeding from the gums and prolonged bleeding following
minor injuries or
cuts
Bleeding from the gums and prolonged bleeding following
minor injuries or
cutsAminocapro
ic acid
Can bleed even minor injury
Desmopressin
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