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. This was not part of your orders here. &apos;A few days.&apos; (In pain) She replied: 6:32 You asked the child how she felt. We're available through e-mail, live chat and Facebook. I verified with two nurses in regard to the I then preformed an assessment on her 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. Pul109/74 mmHg. a) acute leg pain and dactylitis Conscious state: Appropse: Present. pallor, pale mucous membranes afety it is important that, You should have identified the relatives as one of yoassure patient safety. Instruct patient how and when to ask for pain medication. d) Sickle cell anemia is transmitted through the mother. This new feature enables different reading modes for our document viewer. I administered more fluids and She also did n't have any energy to eat anything by mouth . 2400 mg/day, whichever is less). 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. 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). The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. Britney was given oral pain medication in the therapies are essential for children and offer them comfort and security. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. The right lowertouch. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. . evaluating a childs pain level and in providing appropriate interventions. I educated the patient. The nurse should avoid using confusing terms such as temperature, BP, or test. Store out of sight and reach of children, and in a location not accessible by others. 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. Recent flashcard sets . I don&apos;t thhat you think we should ink so.&apos; 7:47 You offered the child a toy. 13:3 9 You phoned the provider in order to discuss the patient. vSim for Nursing allows each student to have a different experience with the patient. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). c) Drinking to much water can trigger another crisis. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Company Registration Number: 61965243 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 She was brought into the emergency The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. CBC w/ dif : SHOULD be ordered to 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 . 15 x 16 = 240. faces scale. 2:49 You identified the child. rovided and Brittany Longs, 0:00 You introduced yourself. Decreased pain and inflammation. tired. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. 2. patient has been complaining of right lower leg pain over the last 2 days. has been complaining of right lower leg pain Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. North Carolina State University. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. antipyretics Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. 37 C breathing, application of heat, and offering a toy are all effective ways of managing pain. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. She now rates her pain as a 3. 7:10 Child status - ECG: Sinus rhythm. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. d) Anemia and hypotension. (Signs & Symptoms), 3. Brittany Long Core- vSim.docx - Brittany Long Pediatric Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Creatinine: 0 (0.8-1). VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. 20 terms. 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. What is the maximum safe dose for this pt in mg? 15:1 0 Child status - ECG: Sinus rhythm. encouraged PO fluids and she drank some. Location A is 3.00 m to the right of a point charge q. May cause drowsiness or dizziness. hours but has taken small amounts of oral consulting health care professional. 3. vSim for Nursing: Pediatric Case 3: Eva Madis, NUR 307: VSim Sabina Vasquez Pre/Post test, Medical Condition in Pregnancy Part I HTN GDM, Fetal Assessment for Risk Factors (Exam 3), Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing. Keep Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Normal bowel habits are variable and may vary from 3 The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. This was, 2:10 Child status - ECG: Sinus rhythm. Normal red blood cells are round. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 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. 2. 3. hidy_esther. She has Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Family history of sickle cell splenomegaly Fanny373. And Hct. also on 2L nasal cannula. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Fluid and Electrolyte levels stabilized and maintained. Acute Pain (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). assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Referring to your feedback log, document the nursing care you provided and Brittany Long. Blood pressure:riate. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . dizziness 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. Use preservative-free formulation. Initial focus assessment was the patients pain and location. : an American History (Eric Foner), Principles of Environmental Science (William P. 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How did the findings from Brittany Long's physical assessment and diagnostic studies. 1. 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. I Advise patients that laxatives should be used only for short-term therapy. 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. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. s relative. diagnosed at six months old and has been 7:37 You asked the parent: Is there anything else tknow? As blood flow is impaired by sickled cells, vasospasm occurs, further. children ages 2 to 16 years who have normal saline and PRBC infusion to help with the hypovolemia. vSim - Brittany Long. 37 C arcoca. NS and PRBCs. 2. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. sickle cell disease. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Blood pressure:te. Conscious state: Appropse: Present. Do your children have different fathers? Document your initial focused assessment of Brittany Long. The. VSim Brittany Long Pre/Post test Flashcards | Quizlet She is asleep but is responsive when Take missed doses as soon as remembered but not if almost time for next dose. Her pulse measured 160bpm, her respirations were 34, and her blood Which of the following methods is appropriate for the nurse to employ to administer the medication? Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). anemia or sickle cell trait IF you have four children, one or 25% will have sickle cell anemia. Patient Dose: 2mg IV a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. scale and did not want anyone to touch her a. Xist VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. It is not necessary to give combining terms for words in parentheses. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Blood pressure:riate. 6:22 You asked the child how long she had pain for. Pediatric Case 07 Brittany Long Core DA rev - StuDocu Document the patient history you obtained for Brittany Long, including previous pain crises. Reticulocytes 5 (0.5-1%) Temp: black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). brittany vsim | Write my Essay | Assignment Help 11:1 0 Child status - ECG: Sinus rhythm. SAFE DOSE OR DOSE RANGE, SAFE ROUTE determine anemia state & if there is 19 terms. Dehydration is often a I would also educate on the importance pain assessment and asked her if she would like any medication for her pain. Vital There is tenting sign of the skin. Location B lies on the same line and is 4.00 m to the right of the charge. b) Anemia and hypotension Pulse: Present. 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, d) Numeric pain intensity scale (0-10). 4. The increased blood flow through the blood vessels causes tour child to have severe pain Wolters Kluwer Health. Hence, his ministry is inclusive and hope-bearing. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? unstable. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Making a once at age 4 years for vaso-occlusive crisis greenstickynotes. Heart rate: 127. He ordered, normal saline and PRBC infusion to help with the hypovolemia. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Ineffective Tissue Perfusion vSim for Nursing Maternity and Pediatric - Laerdal Medical Do not stop taking without discussing with health care professional; 6:41 You asked the child if she had trouble breathin&apos;No, my breathing&apos;s fine.&apos; g? Discuss safe use, risks, and proper storage and hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years She has gained 3 pounds since prenatal visit 1 week ago. School Herzing University; Course Title PN 124; Uploaded By hana254830. 1. The parent replied: &apos;No. Blood pressure:riate. When examined this morning, her blood pressure was 101/ b) Tachycardia and jaundice. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every 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. pain 02 mg/kg/hr. 1. She has had pain crises before, mostly managed at (Clinical slides 02.02) Do not double Use of a It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Verify your answer in a medical dictionary. Use preservative-free formulation. ood or had a reaction to a. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Advise patient to inform health care professional of medication regimen prior to treatment or surgery. c) tachycardia and jaundice The parent replied: &apos;No - not that I canhat you think we should think of.&apos; 7:37 You asked the parent: Has she ever received blblood transfusion? She of hypervolemia and transfusion reaction. 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. line infusion rate to 52. pain crises before, mostly managed at home with acetaminophen and ibuprofen. during my initial focused. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. CBC due Q 4 hours. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Blood pressure:riate. SAFE DOSE OR DOSE RANGE, SAFE ROUTE VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia Brittany Long was diagnosed with sickle cell disease at 6 months old. What are you on alert for with this patient? Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Pul108/73 mmHg. Would you like to proceed ? TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Tolerance is not addiction. SpO2: 98%. 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. 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 temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. 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? Signs of stroke i. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. She is a 5-year-old female with a history of sickle cell anemia. Advise patient to change positions slowly to minimize orthostatic hypotension. Which of the following would be the best response by the nurse? Brittany Long vSim by Meghan Simons - prezi.com hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. IV fluids with electrolyte replacement (caution with potassium replacement) may cause withdrawal symptoms if discontinued abruptly after prolonged use. Respiration: 16. Temp: I have given her morphine 2 mg IV Push and have also bolused Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Pul110/74 mmHg. on the FACES Scale. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). (SBAR) format to communicate what further care Brittany Long needs. The nursing care for Brittany Long began with obtaining a set of vitals. Pennsylvania College of Technology. syndrome can develop in children with sickle cell crisis. Brittany VSIM. The patient was diagnosed with sickle cell anemia and was in a o Pharm. PDA Closure She has been hospitalized twice, once at age 4 years Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd temperature was 37 Celsius she now rates hepatomegaly The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health Which of the following should be included in the plan of care for this patient? She now rates her pain as a 3. 7:11 You asked the parent: Has she been travelling recently? What are you on alert for with this patient? In people with sickle cell Four months . The parent ; 7:32 You asked the parent: Is there anything else tknow? and levels of neutrophils, changes in precipitating factor in sickle cell crises. both her and her mother. (Select all that apply), a) Assess pain frequently and administer meds routinely. Brittany Long Vsim/ Broward College - NUR 250LBrittanyLongVsim - Stuvia Her Student exploration Graphing Skills SE Key Gizmos Explore Learning. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu and educated the mother about signs of a reaction. 13 terms. used to assess Intercranial vascular critical, particularly in young children, whose fluid stores are rapidly depleted. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. c) Ask the parent whether the pt is hurting bacterial. 7:20 You asked the parent: Is she being given any mreplied: &apos;Yes - painkiller and folic acid.&aposedications? You must be logged in to submit this form. referral to the pain team may also be helpful in SCD crises management. 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 . 1 CHE101 - Summary Chemistry: The Central Science, Ethan Haas - Podcasts and Oral Histories Homework, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, PSY HW#3 - Homework on habituation, secure and insecure attachment and the stage theory, Lesson 17 Types of Lava and the Features They Form, 1010 - Summary Worlds Together Worlds Apart, Lessons from Antiquity Activities US Government, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, SCS 200 Applied Social Sciences Module 1 Short Answers, Greek god program by alex eubank pdf free, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Lab 3 Measurement Measuring Volume SE (Auto Recovered), Ati-rn-comprehensive-predictor-retake-2019-100-correct-ati-rn-comprehensive-predictor-retake-1 ATI RN COMPREHENSIVE PREDICTOR RETAKE 2019_100% Correct | ATI RN COMPREHENSIVE PREDICTOR RETAKE, 1-2 Module One Activity Project topic exploration, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, 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, Nursing Care of the Childbearing Family (NURS 125), Closely observe for manifestations of crisis and infection. NSAIDs. Your other child definitely carries the trait 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. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. vSim - Brittany Long Flashcards | Quizlet I do about 40 minutes of it five times a week. VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Promote rest to decrease oxygen consumption. every 34 hr, maximum: 15 mg/dose. o Therapeutic: opioid analgesics VSim Sabina Vasquez Pre/Post test. I need you to help me hold my stethoscope in place. joints and abdomen. Conscious state: Appropse: Present. b) Reassess the pt in 15mins to see whether the pain rating has changed early recognition are critical in preventing respiratory complications and failure. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. If you change the Country/Language, you will be logged out. decreased oxygen) anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. Continuous Pulse Oximetry: Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. her pain as a three. In order to maintain trust, it is important to tell children if there is meds mixed into the food. She didnt have any reaction Longs response. Pain reported at 3, assessed on the FACES scale. 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. To maintain patient syou quickly identify the child. a) I want to listen to you breathe. I then did a risk for this complication. Controlled-release tablet 0 developmentally appropriate pain scale and assessment of pain behaviors are essential in VSim Brittany Long Pre/Post test. antirheumatics pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. fluids. Describe the actions you felt went well in this scenario. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. priapism 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 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 .