The emergency department nurse calls the medical-surgical unit with report on a client in sickle cell crisis who is being admitted. The nurse reports that the client is experiencing priapism and received 30 mg of nifedipine 5 minutes ago. What should the floor nurse include in the client's immediate plan of care?

Nursing care for a client in Sickle cell crisis requires rapid recognition and management of complications caused by vascular occlusion and tissue ischemia. Priapism is a urologic emergency that occurs due to trapped sickled erythrocytes obstructing penile venous outflow, leading to prolonged, painful erection and risk of permanent erectile dysfunction. Management focuses on relieving ischemia and preventing tissue damage through pharmacologic and procedural interventions. Immediate readiness for escalation of care is essential. Rationale: A. Educating the client about pain management and labeling them as a drug seeker is inappropriate and unsafe, especially in sickle cell crisis where pain is severe and physiologically driven by vaso-occlusion. Pain control is a priority intervention and must be managed with adequate analgesia. This response reflects bias and delays urgent care needs. B. Starting a preoperative assessment for emergency surgery is not the immediate priority because priapism is typically managed with urologic interventions rather than immediate surgical preparation. While invasive procedures may be needed, initial care focuses on stabilizing the condition and preparing for possible urologic treatment rather than full surgical clearance. C. Initiating intravenous access and sending blood for type and crossmatch may be appropriate in sickle cell crisis for potential transfusion needs, but it does not address the acute complication of priapism. This action is supportive rather than urgent for the current urologic emergency. Airway, circulation, and immediate complication management take priority over laboratory preparation. D. Ensuring ready access to epinephrine and preparing the client for a possible urologic procedure is appropriate because priapism may require urgent pharmacologic and procedural intervention to restore venous drainage. Urologic management such as aspiration or intracavernosal therapy may be needed if medications like nifedipine are ineffective. Immediate readiness for escalation helps prevent permanent tissue damage and preserves function.