A newly admitted client has a sickle cell crisis. The nurse is planning care based on the assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 92. Which of the following interventions would be implemented first? Assume that there are orders for each intervention.
A. Adjust the room temperature
B. Give a bolus of IV fluids
C. Start O2
D. Administer meperidine (Demerol) 75 mg IV push
Correct Answer: C. Start O2
The most prominent clinical manifestation of sickle cell crisis is pain. However, the pulse oximetry indicates that oxygen levels are low; thus, oxygenation takes precedence over pain relief.
Option A: Warm environment reduces pain and minimizes sickling, it would not be a priority.
Option B: Although hydration is important, it would not require a bolus.
Option D: Demerol is acidifying to the blood and increases sickling.