A 10-year old is admitted to the Emergency Room in a sickle cell crisis. Put the interventions in order by priority.
All options must be used.

Are you taking the medication as prescribed? This is because warfarin is a blood-thinning medication that affects the prothrombin time (PT) and the international normalized ratio (INR).

The PT measures how long it takes for blood to clot, and the INR is a calculation based on the PT that standardizes the results across different laboratories. A normal INR range is 0.8 to 1.1 for people who are not taking warfarin. People who take warfarin usually have a target INR range of 2 to 3, depending on their condition.

An INR of 0.8 means that the blood clots faster than normal, which increases the risk of blood clots and strokes.

This could indicate that the client is not taking enough warfarin or is taking other medications or foods that interfere with warfarin’s effect.

Choice A is wrong because bleeding gums are a sign of excessive bleeding, which could happen if the INR is too high, not too low.

Choice C is wrong because blood in stools is also a sign of excessive bleeding, which could happen if the INR is too high, not too low.

Choice D is wrong because unusual bruising is another sign of excessive bleeding, which could happen if the INR is too high, not too low.

The client practices meditation for 20 minutes once a day. This is an example of an adaptive coping strategy, which is a cognitive or behavioral effort to manage stressful conditions or associated emotional distress.

Meditation can help reduce tension, enhance relaxation, and promote well-being.

Choice A is wrong because the client consumes 3 glasses of wine after a stressful day at work. This is an example of an avoidance coping strategy, which is an attempt to reduce stress by avoiding dealing directly with the problem.

Alcohol consumption can have negative effects on physical and mental health, and does not address the source of stress.

Choice C is wrong because the client keeps all unresolved conflict to themselves. This is an example of an emotion-focused coping strategy, which is an attempt to regulate the emotional distress caused by a stressor.

However, this strategy can be maladaptive if it involves suppressing or denying emotions, which can lead to increased psychological distress and poor interpersonal relationships.

Choice D is wrong because the client consumes a half gallon of ice cream after an argument with a coworker. This is another example of an avoidance coping strategy, which is an attempt to reduce stress by avoiding dealing directly with the problem.

Ice cream consumption can have negative effects on physical health, such as obesity and diabetes, and does not address the source of stress.