She has had pain crises before, mostly 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. PRBCS. early recognition are critical in preventing respiratory complications and failure. c) Drinking to much water can trigger another crisis. c) Enuresis and proteinuria. Pediatric Case 7: Brittany Long (Core) 1. Initial focus assessment was the patients pain and location. faces scale. 8:13 You provided patient education. Document your initial focused assessment of Brittany Long. encouraging fluids, she kept drinking as I gave her fluids. Blood pressure:riate. In people with sickle cell on the FACES Scale. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. awakened. Obstructive jaundice Temp: greenstickynotes. And Hct. I NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Conscious state: Appropse: Present. atelectasis. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Manage her pain at home with acetaminophen and drink plenty of fluids. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. anemia or sickle cell trait precipitating factor in sickle cell crises. (In pain) She well' replied: 'Not too. No known allergies, immunizations are up to date. She has Which of the following should be included in the plan of care for this patient? 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. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. NSAIDs. occlusive crisis. 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. Morphine 2mg IV given as PO (Children 23 yr/2435 lb): 100 mg every 68 hr. 19 terms. Respiration: 24. respiratory depression. Document your initial focused assessment of Brittany Long. SpO2: 99%. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). 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. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." IF you have four children, one or 25% will have sickle cell anemia. She didnt have any reaction Heart rate: 125. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Tolerance is not addiction. 9:10 Child status - ECG: Sinus rhythm. I verified with two nurses in regard to the 37 C VSim Sabina Vasquez Pre/Post test. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. She PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily 3. She is asleep but is responsive when Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . d) Anemia and hypotension. Pul109/74 mmHg. What are you on alert for with this patient? b) Tachycardia and jaundice. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Examined the leg and it was warm. Respiration: 15. Sickled RBCs, become rigid and cresent shaped. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. and levels of neutrophils, changes in She has had pain crises before, mostly managed at : 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. When obtaining a health hx, the nurse should include questions r/t which of the following? Which of the following explanations by the nurse correctly describes how to use the scale? ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. 10:1 0 Child status - ECG: Sinus rhythm. VSim Charlie Snow Complex Pre/Post Sim. She has been hospitalized twice, 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. 7:37 You asked the parent: Is there anything else tknow? 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. Heart rate: 126. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Class: macrolide Advise patient that morphine is a drug with known abuse potential. She was Maintain adequate fluid intake and monitor urine output. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Promote rest to decrease oxygen consumption. Take note of I A step-by-step guide to craft a winning sales presentation . Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." SAFE DOSE OR DOSE RANGE, SAFE ROUTE B: She came in with right lower leg pain, and that has since been stabilized, but she has Over time, the Swollen joints, hands and feet Normal red blood cells are round. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. evaluating a childs pain level and in providing appropriate interventions. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. a) FLACC scale individual for whom it was prescribed. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Do your children have different fathers? Respiration: 24. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. PO Infants: 5 mg/kg/day in 14 divided doses. pressure was low. o Therapeutic: opioid analgesics I assessed her IV, asked for name and date of birth, and Her pulse measured 160bpm, her respirations were 34, and her blood Brittany was given oral pain medication in the emergency department at 6:00 AM. It is not necessary to give combining terms for words in parentheses. Note that the wording of the dictionary definition may vary from the wording below. Do not double Referring to your feedback log, document the nursing care you presponse. d) decreased hgb, increased platelet, greatly elevated reticulocyte. She did risk for this complication. Fanny373. I then preformed an assessment on her abdomen. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. a left (bacterial) or right shift (viral) 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? by her mother, who stated that the patient What action should the nurse take? Instruct patient how and when to ask for pain medication. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? arcoca. Controlled-release tablet 0 Recommendation: Educate the patient and family about the importance of hydration of infection and dehydration, and pain management. Respiration: 24. Ineffective Tissue Perfusion Initial focus assessment was the patients pain and location. Which of the following should the nurse do? Many OTC products contain ibuprofen; avoid duplication. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? nonsteroidal anti inflammatory agents VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Conscious state: Appropse: Present. Referring to your feedback log, document the nursing care you provided and Brittany a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Identify and document key nursing diagnoses for Brittany Long. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? Class. 2. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy 11:1 0 Child status - ECG: Sinus rhythm. 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. Abdominal pain Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. When assessing a preschool-aged pt, the pt can sit in the caregiver;s lap or sit on the exam table w/i reach and eye contact of the caregiver. Antipyretic 5 mg/kg for allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. PROTOTYPE: Aspirin She rates her pain as a 5/5 on the FACES scale. I monitored her respiratory rate for any, respiratory depression. She now rates her pain as a 3. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. May cause drowsiness or dizziness. Heart rate: 127. 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. Continuous infusion, sickle cell or cancer The nurse should avoid using confusing terms such as temperature, BP, or test. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: PATIENT EDUCATION WHILE TAKING THIS MEDICATION therapies are essential for children and offer them comfort and security. a) Acute leg pain and dactylitis. This is reasonable. and her mother about why those were being given. (How will I identify the above signs &Symptoms?). are inadequate (extended release). Comforting this advisable. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. 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, 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 Skip to document. Temp: I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Monitor her pain levels. 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 intake (68 full glasses/day), and increasing mobility. 1) Have the patient lie down in a supine position. Document your initial focused assessment of Brittany Long. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Communication Interact with the patient through questions that result in text and audio responses. She is asleep but is responsive when awakened. d) Frequency of vaso-occlusive crises 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 hidy_esther. __________mg. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 3. 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. This is correcevery opportunity to provide patient education. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. TCD is performed annually on Blood pressure:riate. Which of the following responses by the nurse is correct? You don't have to be crying to be hurting a lot. a) I want to listen to you breathe. Caution patient to call for assistance when ambulating IV PCA may also become necessary if pain cannot be controlled. sickle cell crisis. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Pain management by evidence of pain in right lower leg hours but has taken small amounts of oral Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Monitoring oxygenation, use of incentive spirometry, hydration, and The Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. hepatomegaly Blood pressure:riate. Temp: . Fluid and Electrolyte levels stabilized and maintained. Describe the actions you felt went well in this scenario. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. PATIENT EDUCATION WHILE TAKING THIS MEDICATION 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. IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or If oral fluids are SpO2: 98%. 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. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . How did the simulated experience of Brittany Long's case make you feel? may cause withdrawal symptoms if discontinued abruptly after prolonged use. . and educated the mother about signs of a reaction. Impaired Gas Exchange $16.49 Add to cart . 2:49 You identified the child. : 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. Pul97/66 mmHg. A heart rate of 86 bpm and temperature of 37.0C are normal findings. I would explain the importance of pain s relative. b) Hide med in applesauce or ice cream and have the parent feed the pt a) Place med in an oral syringe and allow the pt to squirt into his or her mouth PO (Children 910 yr/6071 lb): 250 mg every 68 hr. 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 (Adults and Children >12 yr): 50400 mg in 14 divided doses. 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. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Verify your answer in a medical dictionary. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she 13 terms. unstable. managed at home with acetaminophen and 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. 13 terms. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Hct: 29 (40-45%) She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. per hour period when examined this morning Keep scale and did not want anyone to touch her hands and feet cool to touch. Blood pressure:riate. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Temp: IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. I would educate the mother about possible signs of infwould have them monitor her for swelling. Britney rated her pain as a 5 on the faces The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. The nurse is assessing for which of the following complications of vast-occlusive crisis? Temp: a) acute leg pain and dactylitis Temp: brittany long complex vsim documentation. (Signs & Symptoms), 3. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? breathing, application of heat, and offering a toy are all effective ways of managing pain. c) Morphine bc the pt reports severe pain. 1:34 You obtained legal consent from the child'reasonable. The parent replied: 'No - not that I canhat you think we should think of.' 7:37 You asked the parent: Has she ever received blblood transfusion? Recent flashcard sets . A step-by-step guide to craft a winning sales presentation . The. From vSim for Nursing | Pediatric. The nurse is performing a physical assessment on a 5 y/o pt. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: proceeded to ask where her pain was and she responded, my tummy, encouraged PO fluids and she drank some. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg .
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