Sonya Murray is a 32-year-old with sickle cell disease. She…
Sonya Murray is a 32-year-old with sickle cell disease. She has been fairly healthy until this week, when she developed a cold that settled in her chest, resulting in congestion and a productive cough of thick green sputum. She has no appetite and has not had much to eat or drink for a few days. Today she is admitted with painful knees and back. She says that it hurts so bad she can hardly move around and has come to the hospital for pain relief. She says that she has been admitted to the hospital 5 or 6 times previously for similar painful episodes. Her sclera are icteric, mucous membranes are dry, skin is warm, and knees are swollen, hot, and painful to touch. She appears short of breath and oxygen is administered. Vital signs are: 38.9 C, 112, 30, 96/48, 93% on 2 liters nasal cannula. The following laboratory values were reported: Reversal of the sickling crisis may be facilitated by which of the following?