A nurse is performing tracheostomy care for a client and suctioning to remove copious secretions. Which of the following actions should the nurse take?

A. Fresh frozen plasma: Fresh frozen plasma contains clotting factors, including factor VIII, but it is not the primary treatment for hemophilia A. While it can be used in emergency situations to temporarily increase clotting factor levels, it is not typically administered prophylactically before dental procedures.
B. Recombinant factor VIII: This is the correct answer. Recombinant factor VIII is the treatment of choice for individuals with hemophilia A. It is administered to replace the deficient factor VIII in the blood, thereby promoting clot formation and preventing excessive bleeding during surgical procedures such as wisdom teeth extractions.
C. Packed red blood cells (RBCs): Packed red blood cells are not typically indicated for the treatment of hemophilia A. While they may be necessary if significant blood loss occurs during the procedure, the primary treatment is replacement of the deficient clotting factor.
D. Prophylactic antibiotics: Prophylactic antibiotics may be prescribed to prevent infection following dental procedures, especially in individuals with bleeding disorders who are at increased risk of infection due to compromised immune function. However, the primary treatment for hemophilia A prior to dental procedures is replacement therapy with clotting factor concentrates like recombinant factor VIII.

A. Provide reassurance to the client and parents: While reassurance is important, it is not the priority action when caring for an adolescent client with a newly applied fiberglass cast for a fractured tibia. Ensuring adequate neurovascular status is critical to prevent complications associated with impaired circulation or nerve function.
B. Perform a neurovascular assessment: This is the correct action and the priority when caring for a client with a newly applied cast. The nurse should assess the client's neurovascular status by evaluating circulation, sensation, and movement distal to the casted limb. Changes in color, temperature, sensation, or movement could indicate impaired circulation or nerve function, which require immediate intervention to prevent complications such as compartment syndrome.
C. Apply an ice pack to the casted leg: While applying ice may help reduce swelling and discomfort, it is not the priority action when caring for a client with a newly applied cast. Additionally, applying ice directly to the cast may not effectively reach the skin and underlying tissues, potentially causing discomfort without providing significant benefit.
D. Explain the discharge instructions to the client and parents: Providing discharge instructions is important for client education, but it is not the priority action immediately after applying a cast. Ensuring the client's safety and well-being by performing a neurovascular assessment takes precedence to identify and address any potential complications associated with the cast.