Tony Wallace sickle cell Case

Tony Wallace is a 24-year old young man with known sickle cell anemia who was admitted yesterday experiencing an acute pain episode. He has been treated with morphine, Toradol, Benadryl, and Phenergan. He has a peripheral IV with normal saline infusing at 100 mL/hour and a PCA with morphine running at 2 mg/hour. Tony is not happy to receive morphine as this drug causes severe itching. Tony has been sleeping most of the night, but he has requested Phenergan and Benadryl about every 4 or 5 hours since yesterday afternoon. The last time he received Benadryl and Phenergan was at 4:00 a.m. He had his third dose of Toradol at 4:30 a.m. Tony has just woken up and is calling out. Patient Overview Tony Wallace Age 24 years Weight 66 kg Race African American Gender Male Height 178 cm Religion Methodist Major Support Mother Allergies No known allergies Immunizations Current; receives annual flu vax Initial Vital SignsMedical HistoryClinical Findings Provider's Orders Initial Vital Signs