Which intervention is a priority for a hemophilic child who has fallen and badly bruised his leg?

A.Growth of that leg may be affected.

When a fracture occurs near the epiphyseal plate of a long bone, such as the femur, there is a risk of damage to the growth plate. The growth plate (epiphyseal plate) is responsible for longitudinal bone growth in children. If the growth plate is injured or damaged during the fracture, it can potentially lead to growth disturbances and affect the growth of that leg.

B. Risk for infection at this location is increased: While any fracture has a risk of infection, the proximity to the epiphyseal plate doesn't necessarily increase the risk of infection.

C. Long bones contain marrow, which increases the risk for anemia: The presence of bone marrow in long bones is unrelated to the potential effects on bone growth after a fracture near the epiphyseal plate.

D. Fracture repair will necessitate prolonged traction: The use of traction for fracture repair can vary depending on the type and location of the fracture. However, the primary concern with a fracture near the epiphyseal plate is its potential impact on bone growth.

A. Appropriate dose of aspirin and rest: Aspirin is an antiplatelet medication that can worsen bleeding in individuals with hemophilia. It should be avoided. Rest alone is not sufficient in this situation.

B. Immobilization of the leg and a dose of ibuprofen: Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding. Immobilizing the leg may help prevent further injury, but it does not address the underlying bleeding issue or provide the necessary clotting factor.

C. Heating pad and administration of factor VIII concentrate: While the administration of factor VIII concentrate is appropriate, the use of a heating pad is not advisable, as it can potentially worsen bleeding by dilating blood vessels in the area.

D. Pressure on the site and administration of the required clotting factor.

Hemophilia is a bleeding disorder in which the blood doesn't clot properly. When a hemophilic child has a significant bruise or bleeding, it is crucial to administer the specific clotting factor that they are deficient in (Factor VIII or IX) to stop the bleeding. Applying pressure to the site can also help control bleeding.

In summary, option D is the priority because it directly addresses the bleeding issue in the child with hemophilia by applying pressure to the site and administering the necessary clotting factor. This is crucial in preventing further bleeding and complications.