Question

The ED physician completes the assessment and diagnosis Mary with a vasoocculsive sickle cells crisis, probably secondary to pneumonia.

10. Which prescription should the nurse anticipate?

1. Administer meperdine (Demerol) intravenously

2. Admit Mary to a private room and keep her in reverse isolation

3. Infuse 5% Dextrose in 0.33% NS at 75 mL/hr via pump

4. Insert a 22 French indwelling urinary catheter with an urimeter

Answer 1

The nurse should anticipate the order to intravenously hydrate the patient with either 5%dextrose or normal saline. So the answer is option 3.Vaso-occlusive crisis is treated with vigorous intravenous hydration and analgesics. Intravenous fluids is used to correct dehydration and to reduce insensible fluid loss. Normal saline and 5% dextrose in saline can be used for rehydration.

Intravenous meperidine should not be used as a first-line medication for sickle cell crisis because it is toxic to the nervous system.

Sickle cell crisis doesn't require a reverse barrier nursing technique.. Reverse barrier nursing is used when patients are more vulnerable to get a infection from the nurse for eg like in toxic epidermal necrolysis or in Steven John's syndrome, where the natural barrier of the skin is affected.