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Case study 8

Ms. Fox indicates typical of her sickle cell anemia as a child and has had multiple crises requiring hospitalizaton. Ms. Fox states that the pain in her chest is an “8” on a 0 to 10 pain scale. She describes the pain as a “constant burning pain.” Her vital signs are temperature of 100.8°F (38.2 ° C), blood pressure 120/76, pulse 96, and respiratory rate of 22. Her oxygen saturation on room air is 94%.She is hav ing some difficulty breathing and is placed on 2 liters of oxygen by nasal cannula. Ms. Fox explains that she took Extra Strength Tylenol for the past two days in an effort to manage the pain, but when this did not work and the pain got worse, she came in for a stronger pain medication. She explains that in the past she has been given morphine for the pain and prefers to use the patient-controlled analgesia (PCA) pump. Blood work reveals the following values: white blood cell count (WBC) 18,000 cells/mm³ red blood cell count (RBC) 3x10⁶, mean corpuscular volume (MCV) 70 µm³, red cell distribution width (RDW) 20.4%, hemoglobin (Hgb) 7.5 g/dL, hematocrit (Hct) 21.8%, and reticulocyte count 23%. Ms. Fox is admitted for pain management, antibiotic treatment, and respiratory support.

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