c) Sickled cells clump together and cause the blood to become thicker, preventing blood flow through the smaller vessels, causing decreases oxygenation and increased pain in the affected area Identify and document key nursing diagnoses for Brittany Long. 9:31 You gave the child a sip of juice. Normal red blood cells are round. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. If you change the Country/Language, you will be logged out. (In pain) She. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Continuous infusion, sickle cell or cancer 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? Blood pressure:te. 1:34 You obtained legal consent from the child'reasonable. Voc Latin page 24. and her mother about why those were being given. This was not part of your orders here. sickle cell crisis. Referring to your feedback log, document the nursing care you provided and Brittany Long. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. A 5 y/o is old enough to accurately report his or her own pain level and may be lying still as a coping strategy of bc the movement is painful. 1. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Place the steps of an abdominal assessment in order. The padon't think so.' rent replied: 'No. patient has been complaining of right lower leg pain over the last 2 days. Sickled RBCs, become rigid and cresent shaped. Sickle Cell Anemia: is a blood disease that affects red blood cells. In the ED Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. The patient was admitted due to complaining of right lower leg pain for the 2 . IV fluids with electrolyte replacement (caution with potassium replacement) Heart rate: 128. Use preservative-free formulation. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options Designed to simulate real nursing scenarios, vSim for Nursing, co-developed by Laerdal Medical and Wolters Kluwer, allows students to interact with patients in a safe, realistic online environment. Management of Care: What needs to be done for this Patient Today? Respiration: 24. In a vaso-occlusive crisis / painful She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. 34 hr initially. hands and feet cool to touch. A step-by-step guide to craft a winning sales presentation . She The increased blood flow through the blood vessels causes tour child to have severe pain 37 C and is The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis. Abdominal pain Your name, posi t on (RN), unit you are working on SITUATION The patient is Brittany Long, a 5-year-old African American female with a history of sickle cell disease whom was diagnosed at 6 months old. Assess patient and caregiver knowledge of how to avoid crisis. PO (Children 36 yr): 2060 mg in 14 divided doses. She was brought into the emergency department during the night by her mother, who stated that the patient has been complaining of right lower leg pain over the last 2 days. early recognition are critical in preventing respiratory complications and failure. 37 C doses. The nurse is teaching Brittany how to use the FACES scale to rate pain. Before discharging Brittany Long and her family, I would educate them on how to I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: She has had pain crises before, mostly managed at The nurse is performing a physical assessment on a 5 y/o pt. Morphine 2mg IV given as Communication Interact with the patient through questions that result in text and audio responses. I called her provider to see what else I should do. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. pallor, pale mucous membranes Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS), Sickle Cell Anemia: is a blood disease that affects red blood cells. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. I educated the patient. for a fever. a) Acute leg pain and dactylitis. She has been IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? Diagnosed with sickle cell disease at age 6 months. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Controlled-release tablet 0 given. Wolters Kluwer Health. flow and detect the risk for cerebral antirheumatics times/day to 3 times/wk. consulting health care professional. decreased oxygen) regular heart sounds without murmurs. c) Past hospitalizations and Tx SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? He ordered, normal saline and PRBC infusion to help with the hypovolemia. V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? I/O can be calculated by UAP. Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). 2. Course Hero is not sponsored or endorsed by any college or university. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Blood pressure:riate. 3. Pul110/74 mmHg. Document your initial focused assessment of Brittany Long. I monitored her respiratory rate for any 37 C 15 x 16 = 240. Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Care of the childrearing family (nurs420). S: This is Brittany Long. d) Frequency of vaso-occlusive crises 2:49 You identified the child. I hhulsey6. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. Pul106/73 mmHg. CLASSIFICATION: Blood pressure:riate. Promote rest and provide adequate fluids and nutrition. PATIENT EDUCATION WHILE TAKING THIS MEDICATION before discharge. She was admitted to the Pediatric unit this morning . b) Your mom will need to wait outside while I complete your assessment VSim Sabina Vasquez Pre/Post test. I need you to help me hold my stethoscope in place. Heart rate: 107. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. She has been taking small amounts brittany long complex vsim documentation. Blood pressure:riate. Pediatric Case 08 Brittany Long Complex DA - StuDocu s relative. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. NSAIDs. For the latest news, offers and ideas, sign up to our newsletter. Monitor O2 saturation levels Child Life can assist in making the child comfortable and regulating anxiety levels. Use preservative-free formulation. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years The purpose of my YouTube channel is to empower my viewers with the information they need to start, plan, organize and implement evergreen email sequences. Observe for manifestations I don't thhat you think we should ink so.' 7:47 You offered the child a toy. You should have identified the relative, ng the child's before providing Look for signs oection such as fever and shortness of breath. Reticulocytes 5 (0.5-1%) a left (bacterial) or right shift (viral) Recent flashcard sets. splenomegaly Temp: A heart rate of 86 bpm and temperature of 37.0C are normal findings. This is correcevery opportunity to provide patient education. I administered more fluids and Instruct patient how and when to ask for pain medication. She was brought into the emergency VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Which of the following would be the best scale to use w/ this pt? Pain reported at 3, assessed on the FACES scale. Identify and document key nursing diagnoses for Brittany Long. Pul109/74 mmHg. c) Drinking to much water can trigger another crisis. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet Children should never be force to change into a gown. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. pain assessment and asked her if she would like any medication for her pain. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Give Me Liberty! Blood pressure:riate. She now rates her pain as a 3. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." She also didn't have any energy to eat anything by mouth. I would explain the importance of pain Brittany Long Vsim Location: Emergency department 7 AM Brittany Long is a 5-year-old African American female with a history of sickle cell disease, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. 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SAFE DOSE OR DOSE RANGE, SAFE ROUTE DramaQueen66. Transcribed image text: Patient Introduction Brittany Long is a 5-year-old African American female with a history of sickle cell disease, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. encouraging fluids, she kept drinking as I gave her fluids. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . 14:1 0 Child status - ECG: Sinus rhythm. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. management so it does not turn into a crisis. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Hypovolemia by evidence of pale extremities Examined the leg and it was warm. Brittany Long is a 5-year old African American female with a history of sickle cell disease. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Morphine 2mg IV. BUS 5112 Group Project Unit 4-7.pptx ( Final).pdf, In addition in September 2014 the Ministry of Environmental Protection held a, Assessor to record Assessment tasks SITXINV003 Purchase Goods Wakefield, Monitoring Extractive Industries A number of research and advocacy groups have, i State one responsibility of a Secretary 1 mark ii Explain how a Secretary, 2 We cannot walk in hate and be acceptable with God 3 We have to make a decision, Learner Guide Copyright Chisholm 2020 55 Assist the older person to recognise, 7FE69DC0-8ED5-4A85-AF40-3899513A77FC.jpeg, 175 Cockar CJ Kwach and Shah JJA but not before stressing that the Law of, advantages and disadvantages of solar,nuclear energy.docx, D27FCE4D-524A-4914-BC47-839498ADE7B8.jpeg, 1 The answer is D 2 The answer is A The estimated standard error o the mean SE, What is the type of variable pallor A Qualitative nominal B Qualitative ordinal, 10 Discuss the foreign policy of Louis XIV Was he successful Explain He was very, One important aspect of Jesus' ministry is liberating people from the limits imposed by class distinctions in his own time. Neutrophils and bans are While the nurse assesses Brittany, her mother questions why the nurse is checking the pt's heart and lungs when the admitting complaint was leg pain. Class: macrolide The potential difference between the two locations is. I then preformed an assessment on her abdomen. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Referring to your feedback log, document the nursing care you provided and Brittany She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Identify and document key nursing diagnoses for Brittany Long. Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . 3. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. 37 C Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: proceeded to ask where her pain was and she responded, my tummy, encouraged PO fluids and she drank some. I would also educate on the importance Identify and document key nursing diagnoses for Brittany Long. in her right lower legs. She has had pain crises before, mostly a) FLACC scale Brittany Long Core- vSim.docx - Brittany Long Pediatric A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. a) immunization hx Fanny373. Ninon_sassy. respiratory depression. I educated the pati, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Give Me Liberty! Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, d) Frequency of vaso-occlusive crises Making a purchase. On inspection, the pt's skin is flat & w/o erythema. 6:22 You asked the child how long she had pain for. Upto date with . Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. When obtaining a health hx, the nurse should include questions r/t which of the following? Advise patients that laxatives should be used only for short-term therapy. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . on the FACES Scale. Manage her pain at home with acetaminophen and drink plenty of fluids. Which of the following explanations b the nurse is correct? Document your handoff report in the situation-background-assessment- She did Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. temperature was 37 Celsius she now rates IV Neonates: Continuous infusion 00 mg/kg/hr. e) Precipitating events. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. The child looked slightly Hgb 9 (13.5-17) episode Jackson Weber VSim Post-Sim Q's. 10 terms. had a sudden increase in pain in her abdomen. In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. She is asleep but is responsive when c) Sickled cells clump together and cause the blood to become thicker, preventing blood flow through the smaller vessels, causing decreases oxygenation and increased pain in the affected area VSim Brittany Long Pre/Post test. Her pain was a 3/, in her right lower legs. both her and her mother. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. nonopioid analgesics dizziness Temp: a) acute leg pain and dactylitis Family history of sickle cell She has been hospitalized twice, once at age 4 years Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? 13 terms. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, 4. Vaso-occlusive pain crisis from sickle cell anemia Brittany Long vSim Concept Map Meghan Simons NUR 411L Date 1 Patient Diagnosis and Pathophysiology Dx & Patho Diagnosis Dx Sickle cell disease/anemia Pathophysiology Patho Brittany Long is a 5 year old female with a history of sickle cell anemia, who presented to the ED with right . The spleen is enlarged, PO (Children 612 yr): 40150 mg in 14 divided doses. She didnt have any reaction School Herzing University; Course Title PN 124; Uploaded By hana254830. Temp: Heart rate: 127. Discuss safe use, risks, and proper storage and SpO2: 98%. Take note of I verified with two nurses in regard to the I called her provider to see what else I should do. during my initial focused. signs Q2 hours. Impaired Gas Exchange arcoca. diagnosed at six months old and has been She has Four months . scale and did not want anyone to touch her awakened. The parent ; 7:32 You asked the parent: Is there anything else tknow? Temp: 5 touch. Electrolytes Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. department during the night by her mother, who stated that the patient has been complaining Hgb is most recently 7 g/dL. 19 terms. Normal red blood cells are round. Pain management by evidence of pain in right lower leg Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Conversation Concept Lab Transcript Shadow Health. During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. I worked my way up to an hour of cardio per workout session. Brittany was given oral pain medication in the emergency department at 6:00 AM. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Your other child definitely carries the trait Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. 4. c) I am going to take your temp. Heart rate: 126. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Pulmonary edema. Comforting this advisable. Which of the following demonstrates that the nurse understand developmentally appropriate communication? 15:4 1 A patient handoff was performed. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Terms of Use reports of pain. The pt is lying quietly in bed watching TV. SpO2: 98%. 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Finish the reading attached below and complete the | Chegg.com Conscious state: Appropse: Present. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. I then did a (In pain) She well' replied: 'Not too. Location A is 3.00 m to the right of a point charge q. Strict I and New orders have been. The. Tolerance is not addiction. nonsteroidal anti inflammatory agents 7:37 You asked the parent: Is there anything else tknow? fluids. I listened to her lungs (clear and equal bilaterally), checked h(99%), checked her pulse, attached the NIBP (110/74), took heer RR (24), attached the pulse ox r temp (37), did a pain Store out of sight and reach of children, and in a location not accessible by others. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. A step-by-step guide to craft a winning sales presentation . Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health You don't have to be crying to be hurting a lot.
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