A child with hemophilia arrives at the clinic with a swollen knee after falling off a bicycle. Which action should the nurse implement first?

A. Type and cross for possible transfusion: Blood transfusion is not the first-line treatment for a localized joint bleed in hemophilia unless there is significant blood loss or anemia, making this intervention secondary. B. Initiate an IV site and begin infusing normal saline: IV access may be necessary for factor replacement therapy, but immediate management of the joint bleed takes priority to prevent further tissue damage. C. Monitor the child's vital signs frequently: Vital signs are important for overall assessment but do not directly address the acute joint bleed. They are supportive rather than primary interventions. D. Apply ice pack and compression dressing to knee: RICE (Rest, Ice, Compression, Elevation) is the first step in controlling bleeding and swelling in hemophilia-related joint injury. Applying ice and compression helps limit hemorrhage and provides immediate symptomatic relief while preparing for factor replacement therapy.