A 12-year-old male with sickle cell anemia presents with his father with generalized pain that worsened overnight. The client stated his pain is in his knees and ankles. His knees and ankles had a full range of motion on exam and were tender to the touch. Slight swelling in the ankles and knees was observed. The client states that the pain hurts a lot, and he has difficulty sleeping because of the pain. He rates his pain as a ‘7’ on a scale from 0-10. The father denies any recent illnesses or any strenuous activity. The child’s vaccines are current, and he takes no medication daily.
- Establish peripheral vascular access
- Start patient-controlled analgesia, intravenous (IV) morphine
- 250 mL of 0.9% saline over one hour
- Apply lidocaine and prilocaine (EMLA) via a disk or thick cream to the skin 30 minutes before starting the IV
- Complete blood count (CBC); Complete metabolic panel (CMP)
Temperature 98.0o F (37o C)
Pulse 93/minute
Respirations 16/minute
Blood Pressure 113/81 mm Hg
Oxygen saturation 96% on room air
The nurse is implementing care for this client
➢ Click to specify if each nursing action is appropriate or not appropriate
- A. Have a second nurse verify the PCA settings prior to initiation
- B. Apply lidocaine and prilocaine (EMLA) via a disk or thick cream to the skin 30 minutes before starting the IV
- C. Administer supplemental oxygen via nasal cannula
- D. Keep the client nothing by mouth (NPO)
- E. Apply cold compresses to the ankle and knees
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