1.Admit to:
2. Diagnosis: Sickle Cell Crisis
3. Condition:
4. Vital Signs: q shift.
5.Activity: Bedrest
6. Nursing:
7. Diet: Regular diet, push oral fluids.
8. IV Fluids: D5 ½ NS at 100-125 mL/h.
9. Special Medications:
-Oxygen 2 L/min by NC or 30-100% by mask.
-Meperidine (Demerol) 50-150 mg IM/IV 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 [tabs125,250,500 mg].
-Ondansetron (Zofran) 4 mg PO/IV q4-6h prn nausea or vomiting.
10. Symptomatic Medications:
-Zolpidem (Ambien) 5-10 mg qhs prn insomnia.
-Docusate sodium (Colace) 100-200 mg PO qhs.
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. Extras: CXR.
12. Labs: CBC, SMA 7, blood C&S, reticulocyte count,
blood type and screen, parvovirus titers. UA.
