19 terms. She looked visually uncomfortable and reported feeling pain, a 6/10 on the She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. No known allergies, immunizations are up to date. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. 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. PO (Children 36 yr): 2060 mg in 14 divided doses. 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, Protect it from theft, and never give to anyone other than the Conscious state: Appropse: Present. Promote rest and provide adequate fluids and nutrition. Circulating sickle cells are hemolysized by the. What are you on alert for with this patient? tired. 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. Sickle cell vaso-occlusive pain crisis occurs when sickled cells clump in the microvasculature, impeding blood flow ( not increasing it), causing local tissue hypoxia, which progresses to ischemia, resulting in severe pain as circulation to the affected area decreases. 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. Temp: 37.3. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? I also started incorporating more strength training into my gym routine. Heart rate: 128. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. NURS 3440 (NURS3440) Institution. Pulse: Present. Blood pressure:te. PO (Children <3 yr): 1040 mg in 14 divided doses. has been complaining of right lower leg pain Which of the following would be the best response by the nurse? of infection and dehydration, and pain management. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. CBC w/ dif : SHOULD be ordered to She has been hospitalized twice, once at age 4 years : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. When examined this morning, her blood pressure was 101/ Heart rate: 127. 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 spleen is enlarged, The parent ; 7:32 You asked the parent: Is there anything else tknow? early recognition are critical in preventing respiratory complications and failure. X SAFE DOSAGE 34 hr initially. Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. care professional if symptoms persist or worsen. Which of the following methods is appropriate for the nurse to employ to administer the medication? kuuleinani1102. Normal red blood cells are round. 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. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. CLASSIFICATION: After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? PURPOSE FOR TAKING THIS MEDICATION, Treatment of: 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. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation She has had Heart rate: 127. Vaso-occlusive pain crisis from sickle cell anemia 37 C administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Acute: (related to dehydration The parent replied: &apos;No - not that I canhat you think we should think of.&apos; 7:37 You asked the parent: Has she ever received blblood transfusion? 13 terms. Blood pressure:riate. Terms of Use risk for this complication. I would explain the importance of pain What are you on alert for with this patient? Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. c) Drinking to much water can trigger another crisis. Blood pressure:riate. Strict I and intake (68 full glasses/day), and increasing mobility. 15:1 0 Child status - ECG: Sinus rhythm. Take note of a) Place med in an oral syringe and allow the pt to squirt into his or her mouth bacterial. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu As blood flow is impaired by sickled cells, vasospasm occurs, further. IV PCA may also become necessary if pain cannot be controlled. Maintain adequate fluid intake and monitor urine output. Find all solutions of the following equation. Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . Document the patient teaching that you would provide for Brittany Long and her family for a vaso-occlusive crisis episode and once at age 3 years for a fever. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. on the FACES Scale. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. It is not necessary to give combining terms for words in parentheses. V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia Ninon_sassy. Class. acid supplement taken daily. Skip to document. CBC due Q 4 hours. Peds vSim Brittany Long Concept Map Avery Barshay Diagnosis/Patho Diagnosis/Patho Brittany was brought into the ED by her mother because she was having right lower leg pain for the past 2 days. Sets found in the same folder. Dehydration is often a PO (Children 68 yr/4859 lb): 200 mg every 68 hr. SpO2: 98%. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. SpO2: 98%. Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . o Pharmacologic: opioid agonists In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. children ages 2 to 16 years who have and pain management. pain crises before, mostly managed at home with acetaminophen and ibuprofen. 7:37 You asked the parent: Is there anything else tknow? 2. c) Ask the parent whether the pt is hurting The potential difference between the two locations is. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Jackson Weber VSim Post-Sim Q's. 10 terms. Pediatric Case 07 Brittany Long Core DA rev, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. School Herzing University; Course Title PN 124; Uploaded By hana254830. Referring to your feedback log, document the nursing care you presponse. NSAIDs. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. 3. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. lymphocytes monocytes increase is treat it. Recent flashcard sets. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. 6:22 You asked the child how long she had pain for. Conscious state: Appropse: Present. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Examined the leg and it was warm. Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. I Jackson Weber VSim Post-Sim Q's. 10 terms. A step-by-step guide to craft a winning sales presentation . She Advise patient to change positions slowly to minimize orthostatic hypotension. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Respiration: 24. PO Infants: 5 mg/kg/day in 14 divided doses. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached I don&apos;t thhat you think we should ink so.&apos; 7:47 You offered the child a toy. female with a history of sickle cell disease, I verified with two nurses in regard to the She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. The faulty diagnosed at six months old and has been If you change the Country/Language, you will be logged out. SpO2: 97%. nonopioid analgesics Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? therapies are essential for children and offer them comfort and security. d) Anemia and hypotension. managed at home with acetaminophen and (How will I identify the above signs &Symptoms?). Hct: 29 (40-45%) may cause withdrawal symptoms if discontinued abruptly after prolonged use. Store out of sight and reach of children, and in a location not accessible by others. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. precipitating factor in sickle cell crises. She is asleep but is responsive when takes regular folic acid supplement as prescribed. (In pain) She. abdomen is generally tender. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Heart rate: 127. New orders have been. 15 x 16 = 240. Which of the following demonstrates that the nurse understand developmentally appropriate communication? I 8:13 You provided patient education. provided education to Respiration: 24. PRBCS. From vSim for Nursing | Pediatric. Her pain was a 3/, in her right lower legs. Pul106/72 mmHg. Patient Dose: 2mg IV Sigle prn dose of morphine 2mg was administered. times/day to 3 times/wk. a left (bacterial) or right shift (viral) pain, shortness of breath, weakness, slurring of speech) occurs. SpO2: 99%. a. Xist (Signs & Symptoms), 3. prevention of infection and dehydration, and pain management. PDA Closure affect decisions you made about the administration of intravenous (IV) fluid and blood products. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Reticulocytes 5 (0.5-1%) pain 02 mg/kg/hr. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. hands and feet cool to touch. viral. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Respiration: 25. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. b) Tachycardia and jaundice. Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . ECG: normal Sinus rhythm. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. 7:11 You asked the parent: Has she been travelling recently? The right lowertouch. Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family Use preservative-free formulation. I would also educate on the importance Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid This was not part of your orders here. Pain reported at 3, assessed on the FACES scale. 1. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives VS can be monitored and reported by the UAP. her pain as a three. 3. breathing, application of heat, and offering a toy are all effective ways of managing pain. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. I have a weekly show-- Ease Into . has been taking small amounts of oral fluids and continues to receive intravenous vSim for Nursing allows each student to have a different experience with the patient. hepatomegaly a) I want to listen to you breathe. per hour period when examined this morning CLASSIFICATION: (Clinical slides 02.02.2020), It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS). PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . a) immunization hx Family members should be encourage to stay at the, bedside to offer comfort and help to minimize the tremors of hospitalization, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, Sickle cell anemia is an inherited, autosomal recessive disorder characterized by an abnormal form, of hemoglobin in the RBC. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. pallor, pale mucous membranes Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. s relative. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Manage her pain at home with acetaminophen and drink plenty of fluids. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. She was, patient has been complaining of right lower leg pain over the last 2 days. Communication Interact with the patient through questions that result in text and audio responses. I, 6:58 You asked the parent: Has she been eating and parent replied: &apos;Yes.&apos; drinking normally? 26% She was brought into the ED during the night Voc Latin page 24. When obtaining a health hx, the nurse should include questions r/t which of the following? consulting health care professional. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, prescribed was given for her pain. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 9:31 You gave the child a sip of juice. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. She was Instruct patient how and when to ask for pain medication. __________mg. arcoca . Respiration: 24. 7:11 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? Naltrexone: -opioid receptor antagonist that reduces the. b) Hide med in applesauce or ice cream and have the parent feed the pt Initial focus assessment was the patients pain and location. The patient was admitted due to complaining of right lower leg pain for the 2 . 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 . Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. What is the maximum safe dose for this pt in mg? She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Respiration: 15. 240 Tolerance is not addiction. Visual disturbances. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT She has been Before discharging Brittany Long and her family, I would educate them on how to during my initial focused. PROTOTYPE: Aspirin Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Continuous Pulse Oximetry: 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. 2) Inspect abdomen for size and shape. Temp: 1. Document the patient history you obtained for Brittany Long. Fluid and Electrolyte levels stabilized and maintained. o Therapeutic: opioid analgesics These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . The nurse is assessing for which of the following complications of vast-occlusive crisis? : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. 6a Daily Routine. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without given. Pul108/73 mmHg. She has Making a 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 hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). I administered more fluids and Conscious state: Appropse: Present. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? 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