Sickle Cell Crisis

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2. Diagnosis: Sickle Cell Crisis

3. Condition:

4. Vital signs: q shift.

5. Activity: Bedrest

6. Nursing:

7. Diet: Regular diet, push oral fluids.

9. Special Medications:

-Meperidine (Demerol) 50-150 mg IM/IV/SC q4-6h prn pain.

-Hydroxyzine (Vistaril) 25-100 mg IM/IV/PO q3-4h prn pain.

-Morphine sulfate 10 mg IV/IM/SC q2-4h prn pain OR

-Ketorolac (Toradol) 30-60 mg IV/IM then 15-30 mg IV/IM q6h prn pain

(maximum of 5 days). -Acetaminophen/codeine (Tylenol 3) 1-2 tabs PO q4-6h prn. -Folic acid 1 mg PO qd.

-Penicillin V (prophylaxis), 250 mg PO qid [tabs 125,250,500 mg]. -Prochlorperazine (Compazine) 5-10 mg PO or IM q6h prn nausea or vomiting.

Vaccination:

-Pneumovax before discharge 0.5 cc IM x 1 dose. -Influenza vaccine (Fluogen) 0.5 cc IM once a year in the Fall.

11. Labs: CBC, SMA 7, blood C&S, reticulocyte count, blood type and screen, parvovirus titers. UA.

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