The RN is performing a health history and physical assessment on a 12 year old African American male in the emergent care clinic

The RN is performing a health history and physical assessment on a 12 year old African American male in the emergent care clinic. He has sickle cell anemia and is waiting for a stem cell transplant. He had a splenectomy 2 years ago. He is responsible for taking folic acid and hydroxyurea daily. On his way home from school, a “kid shoved him” and he injured his right knee. His sister, who has an upper respiratory infection, wanted to take him to the hospital but he refused. When his mother returns home late in the evening, his knee is visibly swollen, he has pain “all over” and he is gasping for breath.