o Therapeutic: opioid analgesics SpO2: 98%. Heart rate: 127. takes regular folic acid supplement as prescribed. X SAFE DOSAGE The nurse is performing a physical assessment on a 5 y/o pt. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. Jackson Weber Complex Pre/Post Quiz. splenomegaly I have a weekly show-- Ease Into . On inspection, the pt's skin is flat & w/o erythema. No known allergies, immunizations are up to date. reports of pain d) Frequency of vaso-occlusive crises 37 C In people with sickle cell joints and abdomen. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. Respiration: 25. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. You should have asked the relative about any known health problems. 4. Temp: Referring to your feedback log, document the nursing care you presponse. female with a history of sickle cell disease, There is tenting sign of the skin. Pul109/74 mmHg. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Monitor her 02 sat and keep above 94%. slurred speech, What Assessments will focus on for this patient? hhulsey6. 19 terms. Recommendation: Educate the patient and family about the importance of hydration Protect it from theft, and never give to anyone other than the Pul106/72 mmHg. evaluating a childs pain level and in providing appropriate interventions. 37 C Obstructive jaundice She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. managed at home with acetaminophen and a) immunization hx The child looked slightly b) Reassess the pt in 15mins to see whether the pain rating has changed When examined this morning, her blood pressure was 101/ normal saline and PRBC infusion to help with the hypovolemia. Before discharging Brittany Long and her family, I would educate them on how to antirheumatics 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? 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. a) Acute leg pain and dactylitis. 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 . precipitating factor in sickle cell crises. NSAIDs. Fluid and Electrolyte levels stabilized and maintained. Heart rate: 127. Brittany To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. department during the night by her mother, who stated that the patient has been complaining proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Blood pressure:riate. She was admitted to the Pediatric unit this morning . IV fluids with electrolyte replacement (caution with potassium replacement) 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? Temp: Respiration: 24. 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). Do your children have different fathers? Making a purchase. during my initial focused. __________mg. IV Neonates: Continuous infusion 00 mg/kg/hr. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. both her and her mother. respiratory depression. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? and BP now 37 C maintenance fluids at 52 mL/hr. Class. 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. Place the steps of an abdominal assessment in order. decreased oxygen) SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. And Hct. occlusive crisis. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Temp: We're available through e-mail, live chat and Facebook. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. abdomen is generally tender. TCD is performed annually on Morphine 2mg IV. SpO2: 97%. 37 C It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. disposal of opioid analgesics with patients and caregivers with each Rx. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Conscious state: Appropse: Present. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy She has Her skin is quite cold. 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 administered more fluids and Identify and document key nursing diagnoses for Brittany Long. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. 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. sickle cell disease. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Conscious state: Appropse: Present. Many OTC products contain ibuprofen; avoid duplication. Acute: (related to dehydration a) call the provider and request an order for a med for the itching as needed. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). nonsteroidal anti inflammatory agents her pain as a three. (In pain) She. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation SpO2: 98%. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Identify and document key nursing diagnoses for Brittany Long. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, What are you on alert for with this patient? greenstickynotes. Her pain was a 3/5 on FACES scale Decreased pain and inflammation. She also didn't have any energy to eat anything by mouth. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? She is a 5-year-old female with a history of sickle cell anemia. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. signs Q2 hours. (Clinical slides 02.02) She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. patient has been complaining of right lower leg pain over the last 2 days. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. 34 hr initially. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. treat it. The nurse is reviewing lab data on a pt with sickle cell anemia. In a vaso-occlusive crisis / painful CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. Blood pressure:riate. temperature was 37 Celsius she now rates CLASSIFICATION: 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). Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. 18 terms. episode and once at age 3 years for a fever. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). A heart rate of 86 bpm and temperature of 37.0C are normal findings. Monitoring oxygenation, use of incentive spirometry, hydration, and 7:37 You asked the parent: Is there anything else tknow? Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. SpO2: 98%. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. and levels of neutrophils, changes in 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. Patient Dose: 2mg IV She has pain a 6/10 on the faces scale and is receiving morphine to bacterial. Britney rated her pain as a 5 on the faces kuuleinani1102. Jackson Weber VSim Post-Sim Q's. 10 terms. Pain level controlled and maintained, avoiding. e) Precipitating events used to assess Intercranial vascular 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? by her mother, who stated that the patient Promote rest to decrease oxygen consumption. Pul97/66 mmHg. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. o Pharm. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. I/O can be calculated by UAP. SpO2: 99%. 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. Making a Patient C/C right lower leg pain over the last 2 days. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Blood pressure:riate. Which of the following would be the best response by the nurse? ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. electrolyte imbalance and dependence. This was not part of your orders here. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. 37 C Assess dehydration status via CBC, Urinalysis and strict I/O. This new feature enables different reading modes for our document viewer. 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. Pulmonary edema. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . The increased blood flow through the blood vessels causes tour child to have severe pain Location A is 3.00 m to the right of a point charge q. c) Ask the parent whether the pt is hurting 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 . d) Numeric pain intensity scale (0-10). doses. Heart rate: 126. 0:10 Child status - ECG: Sinus rhythm. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? SpO2: 99%. Instruct patient how and when to ask for pain medication. Temp: 37.3. Neutrophils and bans are SAFE DOSE OR DOSE RANGE, SAFE ROUTE b) You must have only transmitted sickle cell anemia to one of your children. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). leg is warm to the nonopioid analgesics She is asleep but is responsive when had a sudden increase in pain in her abdomen. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. 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. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: 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. 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. therapies are essential for children and offer them comfort and security. Reduction of fever. encouraged PO fluids and she drank some. Family history of sickle cell a) Choose the face that looks like how you feel inside. You should have identified the relative, ng the child's before providing 19 terms. She has had pain crises before, mostly 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. Conscious state: Appropse: Present. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Document the patient teaching that you would provide for Brittany Long and her family Labs; daily complete blood count Blood pressure:te. 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. Manage her pain at home with acetaminophen and drink plenty of fluids. The faulty Signs of stroke i. 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. of hydration with patients who have sickle cell anemia. Pre/Post Simulation for Brittany Long. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Fanny373. Assess patient and caregiver knowledge of how to avoid crisis. Temp: The parent, 3:10 Child status - ECG: Sinus rhythm. The right lowertouch. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Which of the following should be included in the plan of care for this patient? arcoca. vSim - Brittany Long. encouraging fluids, she kept drinking as I gave her fluids. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Conscious state: Appropriate. dizziness Creatinine: 0 (0.8-1). a) acute leg pain and dactylitis A step-by-step guide to craft a winning sales presentation . (How will I identify the above signs &Symptoms?). 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. Conscious state: Appropse: Present. Conscious state: Appropse: Present. played with and became more comfortable with. 6a Daily Routine. As blood flow is impaired by sickled cells, vasospasm occurs, further. Take note of Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . I need you to help me hold my stethoscope in place. Pediatric Case : Brittany Long. tired. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. ibuprofen. The nursing care for Brittany Long began with obtaining a set of vitals. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 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 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 . a) Administer the prescribed analgesic as ordered Use of a 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 (SBAR) format to communicate what further care Brittany Long needs. VBVA=45.0V. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Which of the following explanations b the nurse is correct? . 2400 mg/day, whichever is less). over the last 2 days. DramaQueen66. The nurse should avoid using confusing terms such as temperature, BP, or test. 26% may cause withdrawal symptoms if discontinued abruptly after prolonged use.
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brittany long vsim steps