Maria Hernandez Scenario 1
Assessment reveals: left knee swollen, red, and tender to touch. Pain is rated 9/10. Temperature is 102.3,
RR 49, B/P 130/74, HR 110 pulse oximeter is 86% on room air. Maria is crying, unable to be consoled. Her
mother is very anxious.
ord
er Step Explanation
1 Start O2 per face mask at 4 L/min Sickle cell crisis occurs and limits oxygenation of tissue resulting in
hypoxia and increased pain
2 Obtain urine specimen for Should be taken prior to trauma of needle stick (lab draw)
urinalysis and culture and
sensitivity
3 Start IV and draw CBC, BMP This avoids multiple sticks (related to IV fluids altering lab values)
and gives baseline lab work to determine other issues or infections
4 Initiate IV fluids d5 ½ NS at 75 IV hydration is needed to prevent dehydration
ml/hour
5 Administer Morphine Sulfate 4 Relieve intense pain of sickle cell crisis
mg/IV per MD order
Assessment reveals: left knee swollen, red, and tender to touch. Pain is rated 9/10. Temperature is 102.3,
RR 49, B/P 130/74, HR 110 pulse oximeter is 86% on room air. Maria is crying, unable to be consoled. Her
mother is very anxious.
ord
er Step Explanation
1 Start O2 per face mask at 4 L/min Sickle cell crisis occurs and limits oxygenation of tissue resulting in
hypoxia and increased pain
2 Obtain urine specimen for Should be taken prior to trauma of needle stick (lab draw)
urinalysis and culture and
sensitivity
3 Start IV and draw CBC, BMP This avoids multiple sticks (related to IV fluids altering lab values)
and gives baseline lab work to determine other issues or infections
4 Initiate IV fluids d5 ½ NS at 75 IV hydration is needed to prevent dehydration
ml/hour
5 Administer Morphine Sulfate 4 Relieve intense pain of sickle cell crisis
mg/IV per MD order
