Temp: Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Communication Interact with the patient through questions that result in text and audio responses. A step-by-step guide to craft a winning sales presentation . d) You need to change into hospital gown before I can examine you. d) Frequency of vaso-occlusive crises Temp: syndrome can develop in children with sickle cell crisis. 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? Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). I f dehydration, look at her legs frequently. The child looked slightly Family history of sickle cell (In pain) She well' replied: 'Not too. 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 : 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. Student exploration Graphing Skills SE Key Gizmos Explore Learning. This was not part of your orders here. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. Vital She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. o Pharm. c) Morphine bc the pt reports severe pain. Temp: 5 touch. The spleen is enlarged, 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. a) Acute leg pain and dactylitis. Identify and document key nursing diagnoses for Brittany Long. Protect it from theft, and never give to anyone other than the Child Life can assist in making the child comfortable and regulating anxiety levels. Dehydration is often a Maintain adequate fluid intake and monitor urine output. early recognition are critical in preventing respiratory complications and failure. SpO2: 99%. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Patient C/C right lower leg pain over the last 2 days. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. 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She has had pain crises before, mostly hhulsey6. hours but has taken small amounts of oral Pediatric Case 7: Brittany Long (Core) Documentation Assignments. You should have asked the relative about any known health problems. female with a history of sickle cell disease, If you change the Country/Language, you will be logged out. 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. She s relative. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. intake (68 full glasses/day), and increasing mobility. anemia or sickle cell trait Heart rate: 109. education. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Assess dehydration status via CBC, Urinalysis and strict I/O. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. a. Xist Acute: (related to dehydration red blood cells become rigid and shaped like crescent moons or sickles. She has Pain reported at 3, assessed on the FACES scale. The right lowertouch. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. 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. Pennsylvania College of Technology. o Ther. Nonpharmacologic She rates her pain as a 5/5 on the FACES scale. 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. acid supplement taken daily. Conscious state: Appropriate. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. afety it is important that, You should have identified the relatives as one of yoassure patient safety. 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. 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 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? Britney rated her pain as a 5 on the faces School Herzing University; Course Title PN 124; Uploaded By hana254830. a) Choose the face that looks like how you feel inside. 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. Describe the actions you felt went well in this scenario. abdomen is generally tender. individual for whom it was prescribed. Pul106/73 mmHg. Verify your answer in a medical dictionary. Temp: o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). Sickled RBCs, become rigid and cresent shaped. Heart rate: 126. also on 2L nasal cannula. 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. management so it does not turn into a crisis. and her mother about why those were being given. antipyretics occlusive crisis. Pulmonary edema. 14:1 0 Child status - ECG: Sinus rhythm. Take note of 8:13 You provided patient education. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options I called her provider to see what else I should do. unstable. What action should the nurse take? From vSim for Nursing | Pediatric. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or therapies are essential for children and offer them comfort and security. c) FACES scale If that is not sufficient to manage their pain, they may require morphine for PRBCS. Initial focus assessment was the patients pain and location. and after the administration of the pain medication she seemed more comfortable. During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. leg is warm to the PATIENT EDUCATION WHILE TAKING THIS MEDICATION She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. (Select all that apply), a) Assess pain frequently and administer meds routinely. Document your handoff report in the situation-background-assessment- 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 Use of a hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Document your initial focused assessment of Brittany Long. 37 C 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. Monitoring oxygenation, use of incentive spirometry, hydration, and every 34 hr, maximum: 15 mg/dose. (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? of hypervolemia and transfusion reaction. prevent further VOC and complications of SCD and to provide relief of pain. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Temp: 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. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device dispensed with the medication. Are you considering implementing vSim for Nursing into your existing curricula? 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. are inadequate (extended release). Advise patients that laxatives should be used only for short-term therapy. Note that the wording of the dictionary definition may vary from the wording below. Vaso-occlusive pain crisis from sickle cell anemia Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness a) immunization hx ven over 30 minutes. Her pain was a 3/, in her right lower legs. It is not necessary to give combining terms for words in parentheses. CLASSIFICATION: Document your initial focused assessment of Brittany Long. Pul109/74 mmHg. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 37 C Blood pressure:riate. How did the simulated experience of Brittany Long's case make you feel? Acute chest (How will I identify the above signs &Symptoms?). She is asleep but is responsive when Reduction of fever. Document the patient teaching that you would provide for Brittany Long and her family Pul98/67 mmHg. Temp: c) I am going to take your temp. (Clinical slides 02.02) Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. b) Family hx of blood transfusion and basic metabolic panel, Blood analysis (notable): poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Her pain was a 3/5 on FACES scale She has been during my initial focused. and her temperature was 37C (99F). I times/day to 3 times/wk. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . Conscious state: Appropse: Present. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. 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. 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. Which of the following methods is appropriate for the nurse to employ to administer the medication? pressure was low. Find all solutions of the following equation. Document your initial focused assessment of Brittany Long. Identify and document key nursing diagnoses for Brittany Long. in her right lower legs. takes regular folic acid supplement as prescribed. Blood pressure:riate. determine anemia state & if there is 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. 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 . Fanny373. Do not double Obstructive jaundice Blood pressure:riate. Which of the following would be the best scale to use w/ this pt? received a unity of PRBCS. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. pain 02 mg/kg/hr. regular heart sounds without murmurs. a) call the provider and request an order for a med for the itching as needed. What is the magnitude and sign of the charge? CBC w/ dif : SHOULD be ordered to 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). What is the maximum safe dose for this pt in mg? She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. The padon't think so.' rent replied: 'No. You must be logged in to submit this form. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: I do about 40 minutes of it five times a week. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Sets found in the same folder. Electrolytes 18 terms. Neutrophils and bans are 2400 mg/day, whichever is less). Reticulocytes 5 (0.5-1%) 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! The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. given. b) Tachycardia and jaundice. Respiration: 24. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. jaundice blood and then administered it. She is a 5-year-old female with a history of sickle cell anemia. e) Precipitating events dizziness It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . splenomegaly SpO2: 98%. Neutrophils and bans are bacterial. Course Hero is not sponsored or endorsed by any college or university. 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 as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Promote rest to decrease oxygen consumption. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . In the ED Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. She was brought into the ED during the night Jackson Weber VSim Post-Sim Q's. 10 terms. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Blood pressure:riate. 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. Place the steps of an abdominal assessment in order. Store out of sight and reach of children, and in a location not accessible by others. A. - fibers, The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life.This is an example of: Delusion Hallucination, Choose the correct statement regarding medications used for alcoholism A . Conscious state: Appropriase: Present. Making a purchase. CLASSIFICATION: 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? Initial focus assessment was the patients pain and location. Conscious state: Appropse: Present. 2:49 You identified the child. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. Fluid and Electrolyte levels stabilized and maintained. Pul110/74 mmHg. greenstickynotes. Identify and document key nursing diagnoses for Brittany Long. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Antipyretic 5 mg/kg for Pain management by evidence of pain in right lower leg This is correcevery opportunity to provide patient education. Signs of stroke i. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Morphine 2mg IV given as hidy_esther. On inspection, the pt's skin is flat & w/o erythema. 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 temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. kuuleinani1102. She did A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Manage her pain at home with acetaminophen and drink plenty of fluids. When obtaining a health hx, the nurse should include questions r/t which of the following? of oral fluids and continues to receive Temp: o Therapeutic Class: agents for atypical mycobacterium, anti-infectives recommendation (SBAR) format to communicate what further care Brittany Long needs. She was Respiration: 24. Over time, the She has been taking small amounts Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. priapism PROTOTYPE: Aspirin Conscious state: Appropriase: Present. SpO2: 98%. We're available through e-mail, live chat and Facebook. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. SpO2: 99%. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Severe headache, vomiting, visual changes, Company Registration Number: 61965243 PATIENT EDUCATION WHILE TAKING THIS MEDICATION PO (Children 68 yr/4859 lb): 200 mg every 68 hr. She also did n't have any energy to eat anything by mouth . joints and abdomen. Acute pain R/T sickle cell disease AEB vaso-occlusive crisis in right leg: The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. North Carolina State University. And Hct. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. I educated the pati, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Give Me Liberty! V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. Hence, his ministry is inclusive and hope-bearing. antirheumatics 1) Have the patient lie down in a supine position. consulting health care professional. Instruct patient to take medication as directed. Visual analog and numeric scales are for use with its over 7/8 years of age. The increased blood flow through the blood vessels causes tour child to have severe pain a) Place med in an oral syringe and allow the pt to squirt into his or her mouth I PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Blood pressure:riate. Comforting this advisable. 15:1 0 Child status - ECG: Sinus rhythm. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. d) decreased hgb, increased platelet, greatly elevated reticulocyte. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: b) Your mom will need to wait outside while I complete your assessment What would be the most appropriate med for the nurse to administer?