What is the best initial nursing action when a child with Hemophilia A presents with a concussion?

• A. Administer Factor
• B. Elevate Head of Bed
• C. Ice the head
• D. Administer analgesics

Answer: (A)

In Hemophilia A, the missing factor VIII means a head injury can bleed more easily, including inside the skull. The most important step is to replace the missing factor promptly to restore normal clotting and prevent dangerous intracranial bleeding. Administering the factor directly addresses the underlying problem and reduces the risk of ongoing hemorrhage, which is the top priority after a concussion in a child with this bleeding disorder.

Other actions are supportive but don’t tackle the core issue: elevating the head can help with pressure later, icing the head is less critical in preventing intracranial bleeding, and analgesics—especially NSAIDs—can worsen bleeding and are not ideal until factor replacement is underway.