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. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. 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. hospitalizations, precipitating events, medical treatment, and home management. SpO2: 97%. Before discharging Brittany Long and her family, I would educate them on how to The faulty viral. Conscious state: Appropriase: Present. 1. Document the patient history you obtained for Brittany Long. Britney rated her pain as a 5 on the faces Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). 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She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Signs of stroke i. Hypovolemia by evidence of pale extremities PROTOTYPE: Aspirin 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). c) Use a dropper to place med in back of the pt's throat Document the patient history you obtained for Brittany Long, including previous pain crises. Heart rate: 127. Document your initial focused assessment of Brittany Long. Strict I and Electrolytes Neutrophils and bans are Communication Interact with the patient through questions that result in text and audio responses. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: I called her provider to see what else I should do. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Assessment for signs and symptoms of dehydration is Britney was given oral pain medication in the Reduction of fever. (SBAR) format to communicate what further care Brittany Long needs. Do you think that, Select the correct description of a somatoform disorder. 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. splenomegaly By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. jaundice nonopioid analgesics Which of the following methods is appropriate for the nurse to employ to administer the medication? o Pharmacologic: opioid agonists care professional if symptoms persist or worsen. She was SpO2: 98%. sickle cell disease. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. fluids. It is not necessary to give combining terms for words in parentheses. The. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Monitor O2 saturation levels ECG: normal Sinus rhythm. It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Recommended dosage is PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 h I/O can be calculated by UAP. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). hands and feet cool to touch. Blood pressure:riate. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. SpO2: 98%. Pul97/66 mmHg. Terms of Use red blood cells become rigid and shaped like crescent moons or sickles. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. shortness of breath, fatigue 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. The nurse is reviewing lab data on a pt with sickle cell anemia. Respiration: 24. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. 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? From vSim for Nursing | Pediatric. unstable. had a sudden increase in pain in her abdomen. flow and detect the risk for cerebral Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Abdominal pain 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 . 2) Inspect abdomen for size and shape. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Conscious state: Appropse: Present. used to assess Intercranial vascular decreased oxygen) Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. doses. and BP now Sets found in the same folder. Maintain adequate fluid intake and monitor urine output. Long-term therapy may cause May cause drowsiness or dizziness. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet Instruct patient to take medication as directed. d) Numeric pain intensity scale (0-10). SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). arcoca. Respiration: 24. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. The nurse is assessing for which of the following complications of vast-occlusive crisis? 7:11 You asked the parent: Has she been travelling recently? Hgb is most recently 7 g/dL. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ (Abnormal) rapidity of the heart ____________________________________. Peds v Sim Brittany Long by Avery Barshay - Prezi Verify your answer in a medical dictionary. Conscious state: Appropse: Present. (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? Manage her pain at home with acetaminophen and drink plenty of fluids. a) Sickle cell anemia is transmitted through he father. Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex 7:10 Child status - ECG: Sinus rhythm. If oral fluids are PATIENT EDUCATION WHILE TAKING THIS MEDICATION In people with sickle cell a) Acute leg pain and dactylitis. She has had pain crises before, mostly managed at Conscious state: Appropriate. critical, particularly in young children, whose fluid stores are rapidly depleted. Protect it from theft, and never give to anyone other than the I verified with two nurses in regard to the c) FACES scale and educated the mother about signs of a reaction. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Respiration: 24. The parent ; 7:32 You asked the parent: Is there anything else tknow? 37 C The nurse is teaching Brittany how to use the FACES scale to rate pain. The nursing care for Brittany Long began with obtaining a set of vitals. I have given her morphine 2 mg IV Push and have also bolused 10:1 0 Child status - ECG: Sinus rhythm. Pul108/73 mmHg. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. 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. Place the steps of an abdominal assessment in order. The parent replied: 'No. Pediatric Case 08 Brittany Long Complex DA - StuDocu 19 terms. Which of the following should be included in the plan of care for this patient? By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). d) Frequency of vaso-occlusive crises She has PATIENT EDUCATION WHILE TAKING THIS MEDICATION Examined the leg and it was warm. Class. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). joints and abdomen. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. hepatomegaly Find all solutions of the following equation. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT Store out of sight and reach of children, and in a location not accessible by others. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. This is reasonable. 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. scale and did not want anyone to touch her a. Xist SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Monitor and note changes in level of consciousness, reports of headache, dizziness, Family history of sickle cell SpO2: 99%. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent When obtaining a health hx on a pt with sickle cell anemia, the nurse should elicit info r/t growth and development, frequency of vaso-occlusive crises, Past hospitalizations and Tx for pain crises, immunization status, hx of blood transfusions, current medication regiment, and precipitating events. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Obstructive jaundice hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. encouraging fluids, she kept drinking as I gave her fluids. She has not had an appetite in the last 24 may cause withdrawal symptoms if discontinued abruptly after prolonged use. On inspection, the pt's skin is flat & w/o erythema. IV PCA may also become necessary if pain cannot be controlled. episode Monitor her pain levels. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . 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. SAFE DOSE OR DOSE RANGE, SAFE ROUTE The safe dosage range for children is 10 to 15 mg/kg/dose. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. lymphocytes monocytes increase is Vital signs q4h Continuous Pulse Oximetry: Monitor O2 saturation levels Labs; daily complete blood count and basic metabolic panel, Blood analysis (notable): Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5 (0.5-1.5%) Electrolytes Creatinine: 0.4 (0.8-1.4). Heart rate: 109. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Monitor her 02 sat and keep above 94%. PO (Children 612 yr): 40150 mg in 14 divided doses. d) Sickle cell anemia is transmitted through the mother. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Identify and document key nursing diagnoses for Brittany Long. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Pediatric Case : Brittany Long. Pul110/74 mmHg. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. She has had pain crises before, mostly Brittany rated her pain and the abdomen is generally tender. Pul109/74 mmHg. a) acute leg pain and dactylitis and levels of neutrophils, changes in Swollen joints, hands and feet I don't think so.' llergies? PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. I then did a 37 C patient has been complaining of right lower leg pain over the last 2 days. Patient C/C right lower leg pain over the last 2 days. Bp is trending low, she has normal saline running at 320 ml/hr and has recently This was, 2:10 Child status - ECG: Sinus rhythm. Vaso-occlusive pain crisis from sickle cell anemia Management of Care: What needs to be done for this Patient Today? Circulating sickle cells are hemolysized by the. He ordered 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Thus, the maximum safe dose is 240 mg. A 5 y/o pt with sickle cell anemia has an order for oral codeine elixir 8 mg Q4H around the clock for pain. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. If that is not sufficient to manage their pain, they may require morphine for She now rates her pain as a 3. Impaired Gas Exchange It is important to use, 8:21 You provided education to the relative regardicondition. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Reticulocytes 5 (0.5-1%) signs Q2 hours. o Pharm. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? There is tenting sign of the skin. I then preformed an assessment on her abdomen. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. __________mg. I monitored her respiratory rate for any, respiratory depression. SpO2: 99%. Disulfiram: NMDA receptor antagonist & GABAA agonist B . There is tenting sign of the skin. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia 15 x 16 = 240. hours but has taken small amounts of oral Do not double She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. We're available through e-mail, live chat and Facebook. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? IV Neonates: Continuous infusion 00 mg/kg/hr. Recent flashcard sets. Conscious state: Appropriase: Present. Caution patient to call for assistance when ambulating hhulsey6. The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health 2. Her The parent, 3:10 Child status - ECG: Sinus rhythm. Use preservative-free formulation. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. nonsteroidal anti inflammatory agents What would be the most appropriate med for the nurse to administer? Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Transcranial Doppler : Could be Document your initial focused assessment of Brittany Long. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 20 terms. 0 mg/kg every 12 hr. pallor, pale mucous membranes 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? She has pain a 6/10 on the faces scale and is receiving morphine to SpO2: 99%. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 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. 37 C 3. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? brittany long complex vsim documentation. 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, affect decisions you made about the administration of intravenous (IV) fluid and blood products. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? You don't have to be crying to be hurting a lot. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. VSim Brittany Long Pre/Post test. Initial focus assessment was the patients pain and location. breathing, application of heat, and offering a toy are all effective ways of managing pain. 15:1 0 Child status - ECG: Sinus rhythm. Initial focus assessment was the patients pain and location. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Sickle Cell Anemia: is a blood disease that affects red blood cells. Document your initial focused assessment of Brittany Long. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Educate patient and family on nutritional and fluid needs. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. temperature was 37 Celsius she now rates You should have identified the relative, ng the child's before providing CLASSIFICATION: 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. Use of a brittany vsim | Write my Essay | Assignment Help 19 terms. anemia or sickle cell trait 9:10 Child status - ECG: Sinus rhythm. individual for whom it was prescribed. 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. Administer oxygen as prescribed if hypoxia is present. 3. She is asleep but is responsive when awakened. 0:10 Child status - ECG: Sinus rhythm. abdomen is generally tender. Acute chest NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE NS and PRBCs. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Conscious state: Appropse: Present. before discharge. and pain management. Brittany Long vSim by Meghan Simons - prezi.com Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Child Life can assist in making the child comfortable and regulating anxiety levels. Temp: PO (Children 910 yr/6071 lb): 250 mg every 68 hr. c) Enuresis and proteinuria. Which of the following responses by the nurse is correct? Pre/Post Simulation for Brittany Long Flashcards | Quizlet Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Ineffective Tissue Perfusion times/day to 3 times/wk. Longs response. of hydration with patients who have sickle cell anemia. a) Choose the face that looks like how you feel inside. SpO2: 98%. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Voc Latin page 24. Brittany Long Complex VSIM.docx - Course Hero PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. Blood pressure:te. Brittany VSIM. Any orders or recommendations you may have for this patient. Would you like to proceed ? With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Acute Pain e) Precipitating events She has been treat it. Respiration: 15. a) I want to listen to you breathe. Promote rest and provide adequate fluids and nutrition. 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. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation Document your . Making a purchase. If you change the Country/Language, you will be logged out. Blood pressure:riate. CBC due Q 4 hours. Situation: Brittany long is a 5-year-old African American female who has a history of a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. female with a history of sickle cell disease, Visual analog and numeric scales are for use with its over 7/8 years of age. 8:10 Child status - ECG: Sinus rhythm. Assess dehydration status via CBC, Urinalysis and strict I/O. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. on the FACES Scale. 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. leg is warm to the The child looked slightly Heart rate: 126. Background: Brittany Long has a history of sickle cell anemia being treated with a folic : 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. SpO2: 98%. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . . As blood flow is impaired by sickled cells, vasospasm occurs, further. Blood pressure:riate. Pain reported at 3, assessed on the FACES scale. both her and her mother. Pul110/74 mmHg. PO Infants: 5 mg/kg/day in 14 divided doses. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. : 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. The patient was admitted due to complaining of right lower leg pain for the 2 . risk for this complication. A. Somatization disorder - manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical, Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? I educated the patient. b) Family hx of blood transfusion 15:4 1 A patient handoff was performed. Many OTC products contain ibuprofen; avoid duplication. a) FLACC scale 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
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