arcoca. Circulating sickle cells are hemolysized by the. 37 C __________mg. (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). Temp: 37.3. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Controlled-release tablet 0 15 x 16 = 240. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Promote rest to decrease oxygen consumption. encouraged PO fluids and she drank some. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu Which of the following methods is appropriate for the nurse to employ to administer the medication? Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Hematuria 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, Infant, Child And Adolescent Nursing (NSG 441). Timely pain management. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Making a purchase. Which of the following should the nurse do? 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. Upto date with . hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). SpO2: 99%. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. May cause drowsiness or dizziness. VS can be monitored and reported by the UAP. Signs of stroke i. individual for whom it was prescribed. 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. Identify and document key nursing diagnoses for Brittany Long. by her mother, who stated that the patient not meeting the childs fluid requirements, IV fluids are necessary. She is on D5NS fluids at 52 mL/hr. Reticulocytes 5 (0.5-1%) leg during assessment. I verified with two nurses in regard to the Temp: Her pulse measured 160bpm, her respirations were 34, and her blood on the FACES Scale. 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! 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. Temp: Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? c) Drinking to much water can trigger another crisis. Location A is 3.00 m to the right of a point charge q. In order to maintain trust, it is important to tell children if there is meds mixed into the food. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). She now rates her pain as a 3. 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. Comforting this advisable. Verify your answer in a medical dictionary. ibuprofen. d) Frequency of vaso-occlusive crises Hypertension and tachycardia are often associated with acute pain. 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? Location B lies on the same line and is 4.00 m to the right of the charge. If oral fluids are PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Pul106/72 mmHg. Recommendation: Educate the patient and family about the importance of hydration Heart rate: 126. and BP now d) decreased hgb, increased platelet, greatly elevated reticulocyte. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. I would also educate on the importance Blood pressure:riate. May cause drowsiness or dizziness. Respiration: 24. 2400 mg/day, whichever is less). Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies, RR: 24 breaths/ min, chest is moving equally, Brachial pulse: 130bpm, strong and regular, Skin has normal elasticity, color is a bit pale and skin is cool, Pt reports pain is in her right lower leg, onset: a few days, Warm touch normal elasticity slightly pale skin is cool, No redness, swelling, infiltration, bleeding, or drainage, Asked patient if sheis feeling better for which she replied, Yesp, I feel better., a) Offer the pt a favorite stuffed toy and distract her by asking about the animal, b) Place a heating pad on the pt leg and have her mother read her a story, e) Encourage deep breathing by having the pt blow bubbles, *Management of sickle cell crisis is aimed at managing pain and promoting circulation. 0:25 You washed your hands. (Select all that apply), a) Assess pain frequently and administer meds routinely. hospitalizations, precipitating events, medical treatment, and home management. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. 34 hr initially. Place the steps of an abdominal assessment in order. pain, shortness of breath, weakness, slurring of speech) occurs. Conscious state: Appropse: Present. Reduction of fever. Heart rate: 126. Respiration: 24. Class. Blood pressure:riate. 37 C Leadership and Management in Nursing (NUR 4773), Advanced Concepts in Applied Behavior Analysis (PSY7709), Intermediate Medical Surgical Nursing (NRSG 250), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Ch. Respiration: 24. nonsteroidal anti inflammatory agents A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. We have noticed you are logged in to ${country}. Situation: Brittany long is a 5-year-old African American female who has a history of o Pharmacologic: opioid agonists Morphine 2mg IV given as Brittany Long - YouTube Jackson Weber VSim Post-Sim Q's. 10 terms. 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. c) Ask the parent whether the pt is hurting Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. home with acetaminophen and ibuprofen. Find all solutions of the following equation. splenomegaly She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. PO (Children <3 yr): 1040 mg in 14 divided doses. 15:4 1 A patient handoff was performed. CLASSIFICATION: c) Past hospitalizations and Tx 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. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). headache The patient was diagnosed with sickle cell anemia and was in a She has gained 3 pounds since prenatal visit 1 week ago. I/O can be calculated by UAP. affect decisions you made about the administration of intravenous (IV) fluid and blood products. Documentation Assignments. 7:11 You asked the parent: Has she been travelling recently? Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. 19 terms. Child Life can assist in making the child comfortable and regulating anxiety levels. 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. A step-by-step guide to craft a winning sales presentation . 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. This is correcevery opportunity to provide patient education. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. greenstickynotes. b) Reassess the pt in 15mins to see whether the pain rating has changed of hydration with patients who have sickle cell anemia. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Note that the wording of the dictionary definition may vary from the wording below. 18 terms. 1:34 You obtained legal consent from the child&apos;reasonable. She Course Hero is not sponsored or endorsed by any college or university. Document your initial focused assessment of Brittany Long. over the last 2 days. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Many OTC products contain ibuprofen; avoid duplication. Blood pressure:riate. Morphine 2mg IV. Nonpharmacologic 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). Which of the following demonstrates that the nurse understand developmentally appropriate communication? Strict I and a) Administer the prescribed analgesic as ordered A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 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. 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. 2) Inspect abdomen for size and shape. SpO2: 98%. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. She has been hospitalized twice, Pediatric Case 7: Brittany Long (Core) 1. Britney was given oral pain medication in the 7:37 You asked the parent: Is there anything else tknow? *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: brittany vsim | Write my Essay | Assignment Help Class. Abdominal pain Instruct patient to take medication as directed. What are you on alert for with this patient? 2:49 You identified the child. 37 C The nurse is teaching Brittany how to use the FACES scale to rate pain. Conscious state: Appropriate. atelectasis. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. a) FLACC scale referral to the pain team may also be helpful in SCD crises management. IF you have four children, one or 25% will have sickle cell anemia. Brittany VSIM. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. 8:13 You provided patient education. PRBCS. Which of the following would be the best response by the nurse? c) tachycardia and jaundice priapism per hour period when examined this morning d)Enuresis and proteinuria. Take missed doses as soon as remembered but not if almost time for next dose. In a vaso-occlusive crisis / painful Identify and document key nursing diagnoses for Brittany Long. I need you to help me hold my stethoscope in place. Respiration: 15. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Heart rate: 127. Normal bowel habits are variable and may vary from 3 given. Monitor O2 saturation levels Jackson Weber Complex Pre/Post Quiz. Her skin is quite cold. 3. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. I educated the patient. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Pul110/74 mmHg. prevent further VOC and complications of SCD and to provide relief of pain. School Herzing University; Course Title PN 124; Uploaded By hana254830. 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). a) Sickle cells cause increased blood flow throughout the body. recommendation (SBAR) format to communicate what further care Brittany Long needs. Vaso-occlusive pain crisis from sickle cell anemia Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Peds v Sim Brittany Long by Avery Barshay - Prezi For the latest news, offers and ideas, sign up to our newsletter. 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. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Her skin is quite cold. What action should the nurse take? hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Brittany Long vSim by Meghan Simons - prezi.com emergency Department at 0600. Before discharging Brittany Long and her family, I would educate them on how to V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia 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 Blood pressure:riate. DramaQueen66. 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 . 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. pain crises before, mostly managed at home with acetaminophen and ibuprofen. Promote rest and provide adequate fluids and nutrition. o Ther. avoid a sickle cell crisis in the future. red blood cells become rigid and shaped like crescent moons or sickles. Which of the following explanations b the nurse is correct? SpO2: 99%. Children should never be force to change into a gown. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). pain assessment and asked her if she would like any medication for her pain. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids b) Family hx of blood transfusion 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. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Document your initial focused assessment of Brittany Long. breakthrough pain. and pain management. Deep. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. She has hidy_esther. (SBAR) format to communicate what further care Brittany Long needs. She was kuuleinani1102. I then preformed an assessment on her abdomen. PO (Children 36 yr): 2060 mg in 14 divided doses. 2. b) Anemia and hypotension Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex Tolerance is not addiction. This was, 2:10 Child status - ECG: Sinus rhythm. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness closely monitor laboratory results reporting any notable , out of range levels , NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE, MEDICATION: Morphine sulfate 2 mg IV (o mg/kg/dose) X 1 a) Place med in an oral syringe and allow the pt to squirt into his or her mouth She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT developmentally appropriate pain scale and assessment of pain behaviors are essential in 19 terms. . The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Hgb is most recently 7 g/dL. 240 New orders have been. 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 A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. a) I want to listen to you breathe. vSim for Nursing Pediatric | Laerdal Medical These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . a. Xist and after the administration of the pain medication she seemed more comfortable. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. You must be logged in to submit this form. unstable. 18 terms. Heart rate: 107. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . and is Protect it from theft, and never give to anyone other than the It is important to use, 8:21 You provided education to the relative regardicondition. Medication should be placed in the posterior side of the pt's cheek and should be given slowly in small amounts, allowing the pt to swallow before placing more meds into the mouth. Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Observe for manifestations c) FACES scale determine anemia state & if there is The parent replied: &apos;No. Monitor her 02 sat and keep above 94%. $16.49 Add to cart . o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Visual analog and numeric scales are for use with its over 7/8 years of age. 1. Brittany Long was diagnosed with sickle cell disease at 6 months old. 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Respiration: 24. nonopioid analgesics 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. Use preservative-free formulation. of oral fluids and continues to receive 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. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Naltrexone: -opioid receptor antagonist that reduces the. used to assess Intercranial vascular Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. Fanny373. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. 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. Brittany Long vSim Documentation Assignment - Homework Score Pain management by evidence of pain in right lower leg No known allergies, immunizations are up to date. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. If that is not sufficient to manage their pain, they may require morphine for proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Monitoring oxygenation, use of incentive spirometry, hydration, and b) You must have only transmitted sickle cell anemia to one of your children. SpO2: 98%. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. A heart rate of 86 bpm and temperature of 37.0C are normal findings. hhulsey6. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Her Referring to your feedback log, document the nursing care you provided and Brittany Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. 37 C And Hct. Maintain adequate fluid intake and monitor urine output. 37 C Do your children have different fathers? The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Document your initial focused assessment of Brittany Long. Pain level controlled and maintained, avoiding. NS and PRBCs. Pul110/74 mmHg. Document your handoff report in the situation-background-assessment- s relative. provided education to The parent ; 7:32 You asked the parent: Is there anything else tknow? Conscious state: Appropriase: Present. IV fluids with electrolyte replacement (caution with potassium replacement) You should have asked the relative about any known health problems. Would you like to proceed ? 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. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. a) Acute leg pain and dactylitis. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy signs Q2 hours. Pediatric OTC Dosing a) Acute leg pain and dactylitis. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Obstructive jaundice Assess patient and caregiver knowledge of how to avoid crisis. Sickle Cell Anemia: is a blood disease that affects red blood cells. acid supplement taken daily. Caution patient to call for assistance when ambulating Pennsylvania College of Technology. normal saline and PRBC infusion to help with the hypovolemia. and her mother about why those were being given. . Monitor and note changes in level of consciousness, reports of headache, dizziness, Identify and document key nursing diagnoses for Brittany Long. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia 13 terms. I also started incorporating more strength training into my gym routine. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? SpO2: 98%. Brittany rated her pain Family history of sickle cell line infusion rate to 52. 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