Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I monitored her respiratory rate for any Britney was given oral pain medication in the c) FACES scale This was not part of your orders here. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. 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. Respiration: 24. 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 a) Sickle cells cause increased blood flow throughout the body. She takes regular folic acid supplement as prescribed. Fanny373. What is the magnitude and sign of the charge? Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. She also didn't have any energy to eat anything by mouth. Longs response. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. This is reasonable. For the latest news, offers and ideas, sign up to our newsletter. 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 Controlled-release tablet 0 18 terms. occlusive crisis. Hgb 9 (13.5-17) for a fever. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? The. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Document the patient teaching that you would provide for Brittany Long and her family A dropper is appropriate for use w/ infants and younger children; older children can take oral meds from a medicine cup or measured medicine spoon. SpO2: 98%. Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. Hence, his ministry is inclusive and hope-bearing. Family history of sickle cell NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: dizziness leg is warm to the And Hct. Pul108/73 mmHg. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. c) Morphine bc the pt reports severe pain. Blood pressure:riate. 37 C I don't think so.' llergies? Look for signs oection such as fever and shortness of breath. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. Impaired Gas Exchange Heart rate: 125. Advise patient to change positions slowly to minimize orthostatic hypotension. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Decreased pain and inflammation. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Blood pressure:riate. Heart rate: 125. Transcranial Doppler : Could be VBVA=45.0V. Skip to document. This was part of your order. of hydration with patients who have sickle cell anemia. Severe pain, usually in bones c) Past hospitalizations and Tx c) Enuresis and proteinuria. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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! PO (Children 68 yr/4859 lb): 200 mg every 68 hr. hhulsey6. managed at home with acetaminophen and Are you considering implementing vSim for Nursing into your existing curricula? I administered more fluids and She has pain a 6/10 on the faces scale and is receiving morphine to The parent, 3:10 Child status - ECG: Sinus rhythm. Temp: times/day to 3 times/wk. Her skin is quite cold. You don't have to be crying to be hurting a lot. Respiration: 15. emergency Department at 0600. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Manage her pain at home with acetaminophen and drink plenty of fluids. Patients who are immobile are at greater Which of the following would be the best scale to use w/ this pt? Conscious state: Appropriase: Present. Long-term therapy may cause Heart rate: 107. episode e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Morphine 2mg IV. May cause drowsiness or dizziness. pain 02 mg/kg/hr. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. 8:10 Child status - ECG: Sinus rhythm. 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. a. Xist syndrome can develop in children with sickle cell crisis. Identify and document key nursing diagnoses for Brittany Long. . electrolyte imbalance and dependence. We're available through e-mail, live chat and Facebook. Sickled RBCs, become rigid and cresent shaped. Respiration: 24. Administer oxygen as prescribed if hypoxia is present. 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. antipyretics PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Student exploration Graphing Skills SE Key Gizmos Explore Learning. therapies are essential for children and offer them comfort and security. I called her provider to see what else I should do. Take missed doses as soon as remembered but not if almost time for next dose. flow and detect the risk for cerebral Patient Dose: 2mg IV I have a weekly show-- Ease Into . red blood cells become rigid and shaped like crescent moons or sickles. episode and once at age 3 years for a fever. VS can be monitored and reported by the UAP. Temp: 37.3. c) I am going to take your temp. precipitating factor in sickle cell crises. You should have asked the relative about any known health problems. Labs; daily complete blood count S: This is Brittany Long. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. If you change the Country/Language, you will be logged out. Location B lies on the same line and is 4.00 m to the right of the charge. Brought into the ED by her mother last night. 19 terms. reports of pain. e) Precipitating events PO Infants: 5 mg/kg/day in 14 divided doses. I monitored her respiratory rate for any, respiratory depression. determine anemia state & if there is Monitor her 02 sat and keep above 94%. Normal red blood cells are round. 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. 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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 . Use of a Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. fluids. Monitor and note changes in level of consciousness, reports of headache, dizziness, I then did a Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Student exploration Graphing Skills SE Key Gizmos Explore Learning. As blood flow is impaired by sickled cells, vasospasm occurs, further. Heart rate: 109. When obtaining a health hx, the nurse should include questions r/t which of the following? black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest This is correcevery opportunity to provide patient education. I do about 40 minutes of it five times a week. o Ther. dispensed with the medication. scale and did not want anyone to touch her 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. Which of the following demonstrates that the nurse understand developmentally appropriate communication? 1:34 You obtained legal consent from the child'reasonable. Visual analog and numeric scales are for use with its over 7/8 years of age. c) Past hospitalizations and Tx c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy The nursing care for Brittany Long began with obtaining a set of vitals. and educated the mother about signs of a reaction. a) Acute leg pain and dactylitis. 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). Which of the following responses by the nurse is correct? Blood pressure:riate. d)Enuresis and proteinuria. She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. children ages 2 to 16 years who have 4. a) Administer the prescribed analgesic as ordered management so it does not turn into a crisis. 9:03 You took a blood sample. maintenance fluids at 52 mL/hr. She was brought into the emergency Identify and document key nursing diagnoses for Brittany Long. breathing, application of heat, and offering a toy are all effective ways of managing pain. Blood pressure:riate. : 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. The parent replied: 'No. 15:4 1 A patient handoff was performed. Her pulse measured 160bpm, her respirations were 34, and her blood 0:25 You washed your hands. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Initial focus assessment was the patients pain and location. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. The patient was diagnosed with sickle cell anemia and was in a She was brought into the ED during the night 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 . She has had pain crises before, mostly managed at Conscious state: Appropse: Present. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. I f dehydration, look at her legs frequently. Making a purchase. 34 hr initially. Monitor O2 saturation levels 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. She looked visually uncomfortable and reported feeling pain, a 6/10 on the The nurse is performing a physical assessment on a 5 y/o pt. Store out of sight and reach of children, and in a location not accessible by others. Promote rest and provide adequate fluids and nutrition. Patient C/C right lower leg pain over the last 2 days. 2:49 You identified the child. Hypovolemia by evidence of pale extremities Document your initial focused assessment of Brittany Long. Identify and document key nursing diagnoses for Brittany Long. greenstickynotes. Neutrophils and bans are Pul97/66 mmHg. o Therapeutic: opioid analgesics Which of the following should be included in the plan of care for this patient? b) Visual analog scale 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? Vaso-occlusive pain crisis from sickle cell anemia Temp: PO (Children <3 yr): 1040 mg in 14 divided doses. 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 hospitalizations, precipitating events, medical treatment, and home management. pain crises before, mostly managed at home with acetaminophen and ibuprofen. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. 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. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer I worked my way up to an hour of cardio per workout session. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. The nurse is teaching Brittany how to use the FACES scale to rate pain. provided education to This new feature enables different reading modes for our document viewer. d) Sickle cell anemia is transmitted through the mother. and the abdomen is generally tender. 37 C Conscious state: Appropse: Present. Continuous infusion, sickle cell or cancer These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. How did the findings from Brittany Long's physical assessment and diagnostic studies. CBC due Q 4 hours. 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. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). 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. North Carolina State University. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids VSim Brittany Long Pre/Post test. risk for this complication. (Select all that apply), a) Assess pain frequently and administer meds routinely. SAFE DOSE OR DOSE RANGE, SAFE ROUTE 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). Brittany rated her pain I stayed to watch for a transfusion reaction. prescribed regular folic acid supplement. Continuous Pulse Oximetry: PROTOTYPE: Morphine. Her skin is quite cold. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. 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. every 34 hr, maximum: 15 mg/dose. She has had pain crises before, mostly Heart rate: 127. (In pain) She well' replied: 'Not too. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. I have given her morphine 2 mg IV Push and have also bolused care professional if symptoms persist or worsen. 7:10 Child status - ECG: Sinus rhythm. 11:1 0 Child status - ECG: Sinus rhythm. SpO2: 98%. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. c) FACES scale of hypervolemia and transfusion reaction. pain, shortness of breath, weakness, slurring of speech) occurs. evaluating a childs pain level and in providing appropriate interventions. She was admitted to the Pediatric unit this morning . A heart rate of 86 bpm and temperature of 37.0C are normal findings. I need you to help me hold my stethoscope in place. used to assess Intercranial vascular vSim - Brittany Long. Blood pressure:te. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Conscious state: Appropse: Present. Respiration: 24. 1. Over time, the She was, patient has been complaining of right lower leg pain over the last 2 days. X SAFE DOSAGE line infusion rate to 52. Creatinine: 0 (0.8-1). Respiration: 24. Acute chest IF you have four children, one or 25% will have sickle cell anemia. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. c) tachycardia and jaundice Hgb is most recently 7 g/dL. nonopioid analgesics Signs of stroke i. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. 19 terms. SpO2: 98%. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device of oral fluids and continues to receive PATIENT EDUCATION WHILE TAKING THIS MEDICATION She is asleep but is responsive when awakened. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. : 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. A step-by-step guide to craft a winning sales presentation . a) I want to listen to you breathe. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Pul109/74 mmHg. What are you on alert for with this patient? A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 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. department during the night by her mother, who stated that the patient has been complaining I then preformed an assessment on her abdomen. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? 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. 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. What action should the nurse take? Find all solutions of the following equation. Documentation Assignments. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Before discharging Brittany Long and her family, I would educate them on how to (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Conscious state: Appropse: Present. Document your initial focused assessment of Brittany Long. Pediatric Case 7: Brittany Long (Core) 1. pressure was low. b) Family hx of blood transfusion Brittany was given oral pain medication in the emergency department at 6:00 AM. (Abnormal) rapidity of the heart ____________________________________. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Temp: 5 touch. a) acute leg pain and dactylitis Conscious state: Appropriase: Present. Document your handoff report in the situation-background-assessment- SAFE DOSE OR DOSE RANGE, SAFE ROUTE The patient was admitted due to complaining of right lower leg pain for the 2 . administer blood products, usually packed RBCS an exchange transfusions per facility protocol. 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. 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? 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. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Temp: decreased oxygen) and BP now In a vaso-occlusive crisis / painful Ineffective Tissue Perfusion PRBCS. vSim for Nursing allows each student to have a different experience with the patient. greenstickynotes. Four months . Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. I would explain the importance of pain PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. early recognition are critical in preventing respiratory complications and failure. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. If oral fluids are Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 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. Initial focus assessment was the patients pain and location. Respiration: 24. Class. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. arcoca. Heart rate: 127. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every 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. Upto date with . Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . d) Frequency of vaso-occlusive crises SpO2: 99%. Pul110/74 mmHg. 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. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. jaundice During my initial focused assessment of Brittany Long I found that her vital signs were hands and feet cool to touch. (Clinical slides 02.02) Brittany Long was diagnosed with sickle cell disease at 6 months old. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 1) Have the patient lie down in a supine position. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, 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.