Your patient is a 26-year-old African-American male who is alert but in severe distress, complaining of pain in his hands and feet, as well as abdominal pain. The pain began this morning but has progressed from an initial rating of 5/10 to a 9/10 at the present time. The patient has a history of sickle cell anemia and denies any trauma. Physical examination reveals cool, diaphoretic skin; pain with palpation to all four abdominal quadrants; splenomegaly; and a priapism. HR = 132, BP = 140/90, RR = 16. Select the most appropriate acute diagnosis and treatment for this patient.

Question

Quizplus · Accepted Answer

This patient's presentation is consistent with a sickle cell vaso occlusive crisis, which is a common complication of sickle cell disease. The appropriate treatment includes high-concentration oxygen, IV therapy with isotonic crystalloids, and narcotics for pain control. Aspirin is contraindicated in sickle cell disease as it can increase the risk of bleeding. Administering ketorolac alone may not provide sufficient pain control for a vaso occlusive crisis. Sickle cell trait typically does not present with symptoms and does not require specific treatment.

Your Patient Is a 26-Year-Old African-American Male Who Is Alert