A nurse is caring for a child in the emergency department (ED). Exhibits For each potential intervention, click to specify if the potential intervention is expected or unexpected for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Potential Intervention Expected Unexpected Rationale Have child tilt head back ✅ Tilting the head back increases the risk of blood being swallowed, which can cause nausea or aspiration. Insert cotton into nostril ✅ Cotton can be ineffective and may dislodge, worsening bleeding. Use gauze or a nasal tampon if needed. Apply ice to bridge of nose ✅ Cold vasoconstricts blood vessels, helping reduce nasal bleeding. Apply pressure to tip of nose for at least 10 min ✅ First-line measure for anterior epistaxis. Correct site is the soft part (lower third) of the nose. Prepare to administer factor VIII ✅ The child has a Factor VIII deficiency (35%), which is diagnostic of Hemophilia A. Factor VIII replacement is the treatment. Prepare to administer topical antifibrinolytic agent ✅ These agents help stabilize clots and are used for mucosal bleeds in hemophilia. Prepare to administer packed red blood cells ✅ Not indicated unless there is severe blood loss with signs of anemia or hemodynamic instability, which is not present here.