a) acute leg pain and dactylitis She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. scale and did not want anyone to touch her Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. greenstickynotes. She has been hospitalized twice, hospitalizations, precipitating events, medical treatment, and home management. Timely pain management. 9:10 Child status - ECG: Sinus rhythm. Temp: 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. I stayed to watch for a transfusion reaction.
vSim for Nursing Maternity and Pediatric - Laerdal Medical Her B: She came in with right lower leg pain, and that has since been stabilized, but she has I educated the patient. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) 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. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. Conscious state: Appropse: Present. Pul110/74 mmHg. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). for a vaso-occlusive crisis episode and once at age 3 years for a fever. home with acetaminophen and ibuprofen. Temp: 37.3. Pain level controlled and maintained, avoiding. 4. 2. Making a She was admitted to the Pediatric unit this morning . Temp: Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Neutrophils and bans are Advise patients that laxatives should be used only for short-term therapy. had a sudden increase in pain in her abdomen. Blood pressure:riate. pallor, pale mucous membranes 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. : 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. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Disulfiram: NMDA receptor antagonist & GABAA agonist B . nonopioid analgesics Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Initial focus assessment was the patients pain and location. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. (In pain) She well' replied: 'Not too. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Blood pressure:riate. b) Tachycardia and jaundice. This was not part of your orders here. Heart rate: 109. I rovided and Brittany Longs, 0:00 You introduced yourself. vSim - Brittany Long. greenstickynotes. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Assess patient and caregiver knowledge of how to avoid crisis. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Maintain adequate fluid intake and monitor urine output. The nurse is performing a physical assessment on a 5 y/o pt. Document your initial focused assessment of Brittany Long. 37 C On inspection, the pt's skin is flat & w/o erythema. brittany long complex vsim documentation. Brittany poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. e) Precipitating events PO (Children <3 yr): 1040 mg in 14 divided doses. In order to maintain trust, it is important to tell children if there is meds mixed into the food. Sigle prn dose of morphine 2mg was administered. SpO2: 98%. 6a Daily Routine. She now rates her pain as a 3. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . She has been hospitalized twice, once at age 4 years temperature was 37 Celsius she now rates 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 crisis. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). c) Drinking to much water can trigger another crisis. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Acute: (related to dehydration She has been
Finish the reading attached below and complete the | Chegg.com assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Respiration: 24. She rates her pain as a 5/5 on the FACES scale. May cause drowsiness or dizziness. also on 2L nasal cannula. Conscious state: Appropse: Present. Document your initial focused assessment of Brittany Long. We're available through e-mail, live chat and Facebook. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. 8:13 You provided patient education. 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. What are you on alert for with this patient? Sets found in the same folder. c) tachycardia and jaundice 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 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. SpO2: 98%. Hypovolemia by evidence of pale extremities Pul108/73 mmHg. 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. PRBCS. Jackson Weber Complex Pre/Post Quiz. She has had pain crises before, mostly Blood pressure:te. 37 C Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Pediatric OTC Dosing Monitor O2 saturation levels 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! Stabilizing fluid levels to assist in relieving pain. sickle cell crisis. Recent flashcard sets . Transcribed image text: Patient Introduction 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. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Pul110/74 mmHg.
Conscious state: Appropse: Present. c) Morphine bc the pt reports severe pain. Place the steps of an abdominal assessment in order. a) immunization hx ECG: normal Sinus rhythm. 2:49 You identified the child. episode Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. Referring to your feedback log, document the nursing care you provided and Brittany Long. Respiration: 24. 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? I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. c) Enuresis and proteinuria. Reticulocytes 5 (0.5-1%) regular heart sounds without murmurs. PO (Children 612 yr): 40150 mg in 14 divided doses. Many OTC products contain ibuprofen; avoid duplication. 13:2 3 You examined the child's legs. Instruct patient to take medication as directed. diagnosed at six months old and has been 1) Have the patient lie down in a supine position. Ineffective Tissue Perfusion her blood pressure was 101 / 70 and her Which of the following would be the best response by the nurse? precipitating factor in sickle cell crises. Respiration: 24. : 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. Heart rate: 127. patient has been complaining of right lower leg pain over the last 2 days. 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. North Carolina State University. The faulty Keep New orders have been 13 terms. 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 . Sickled RBCs, become rigid and cresent shaped. 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. 13 terms. She also did n't have any energy to eat anything by mouth . Identify and document key nursing diagnoses for Brittany Long. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she signs Q2 hours. Diagnosed with sickle cell disease at age 6 months. 2. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth (Abnormal) rapidity of the heart ____________________________________. D5 in 1/2NS IV at 52 mL per hour, codeine elixir 8 milligrams orally every four hours (06-10-14-18-22-02) , acetaminophen Alexa are 240 mg orally every six hours (6-12-18-24), ibuprofen elixir 160 mg orally at 0900 and then q6h , Docusate sodium 100 mg orally once daily at 2000, morphine sulfate 2 mg IV one time dose. SpO2: 99%. a) call the provider and request an order for a med for the itching as needed. Which of the following explanations b the nurse is correct? anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. For the latest news, offers and ideas, sign up to our newsletter. 37 C Vaso-occlusive pain crisis from sickle cell anemia 37 C Conscious state: Appropse: Present. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. SpO2: 99%. Protect it from theft, and never give to anyone other than the ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Recommended dosage is PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 h Your name, posi t on (RN), unit you are working on SITUATION The patient is Brittany Long, a 5-year-old African American female with a history of sickle cell disease whom was diagnosed at 6 months old. individual for whom it was prescribed. Temp: BUS 5112 Group Project Unit 4-7.pptx ( Final).pdf, In addition in September 2014 the Ministry of Environmental Protection held a, Assessor to record Assessment tasks SITXINV003 Purchase Goods Wakefield, Monitoring Extractive Industries A number of research and advocacy groups have, i State one responsibility of a Secretary 1 mark ii Explain how a Secretary, 2 We cannot walk in hate and be acceptable with God 3 We have to make a decision, Learner Guide Copyright Chisholm 2020 55 Assist the older person to recognise, 7FE69DC0-8ED5-4A85-AF40-3899513A77FC.jpeg, 175 Cockar CJ Kwach and Shah JJA but not before stressing that the Law of, advantages and disadvantages of solar,nuclear energy.docx, D27FCE4D-524A-4914-BC47-839498ADE7B8.jpeg, 1 The answer is D 2 The answer is A The estimated standard error o the mean SE, What is the type of variable pallor A Qualitative nominal B Qualitative ordinal, 10 Discuss the foreign policy of Louis XIV Was he successful Explain He was very, One important aspect of Jesus' ministry is liberating people from the limits imposed by class distinctions in his own time. Temp: 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? Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Promote rest and provide adequate fluids and nutrition. 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. 34 hr initially. Discuss safe use, risks, and proper storage and (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Continuous Pulse Oximetry: avoid a sickle cell crisis in the future. The. She was brought into the ED during the night May cause drowsiness or dizziness. Decreased pain and inflammation. Conscious state: Appropriate. If that is not sufficient to manage their pain, they may require morphine for I assessed her IV, asked for name and date of birth, and 37 C her pain as a three. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation Communication Interact with the patient through questions that result in text and audio responses. . vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. 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. o Pharm. Temp: Sickle cell vaso-occlusive pain crisis occurs when sickled cells clump in the microvasculature, impeding blood flow ( not increasing it), causing local tissue hypoxia, which progresses to ischemia, resulting in severe pain as circulation to the affected area decreases. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. She was brought into the emergency Abdominal pain She did flow and detect the risk for cerebral She is a 5-year-old female with a history of sickle cell anemia. Her skin is quite cold. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Blood pressure:riate. This was part of your order. per hour period when examined this morning affect decisions you made about the administration of intravenous (IV) fluid and blood products. Designed to simulate real nursing scenarios, vSim for Nursing, co-developed by Laerdal Medical and Wolters Kluwer, allows students to interact with patients in a safe, realistic online environment. d) Frequency of vaso-occlusive crises joints and abdomen. CBC due Q 4 hours. In people with sickle cell The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. The padon't think so.' rent replied: 'No. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. What is the magnitude and sign of the charge? SpO2: 98%. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Normal red blood cells are round. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy sickle cell disease. She has pain a 6/10 on the faces scale and is receiving morphine to by her mother, who stated that the patient for a fever. I administered more fluids and The child looked slightly over the last 2 days. Dehydration is often a VSim Sabina Vasquez Pre/Post test. I called her provider to see what else I should do. I/O can be calculated by UAP. kuuleinani1102. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Store out of sight and reach of children, and in a location not accessible by others. Heart rate: 127. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? PO Infants: 5 mg/kg/day in 14 divided doses. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Look for signs oection such as fever and shortness of breath.
Pediatric Case 08 Brittany Long Complex DA - StuDocu Brought into the ED by her mother last night. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Do your children have different fathers? blood and then administered it. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Advise patient to change positions slowly to minimize orthostatic hypotension. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. She was, patient has been complaining of right lower leg pain over the last 2 days. provided education to SpO2: 99%. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. I verified with two nurses in regard to the Transcranial Doppler : Could be (Signs & Symptoms), awakened. and educated the mother about signs of a reaction. A step-by-step guide to craft a winning sales presentation . PROTOTYPE: Aspirin 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: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. risk for this complication. Brittany Long Vsim Location: Emergency department 7 AM 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. Advise patient that morphine is a drug with known abuse potential. Take note of VBVA=45.0V. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. She has been taking small amounts spleen, leading to anemia. Assessment for signs and symptoms of dehydration is Her pulse measured 160bpm, her respirations were 34, and her blood 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? __________mg.
Brittany Long Core- vSim.docx - Brittany Long Pediatric Document your handoff report in the situation-background-assessment- 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. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. 240 Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Blood pressure:riate. has been complaining of right lower leg pain 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. department during the night by her mother, who stated that the patient has been complaining splenomegaly occlusive crisis. dispensed with the medication.
The parent, 3:10 Child status - ECG: Sinus rhythm. 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). The nursing care for Brittany Long began with obtaining a set of vitals. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. 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. 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. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. She didnt have any reaction Severe pain, usually in bones given. Identify and document key nursing diagnoses for Brittany Long. Document your initial focused assessment of Brittany Long. red blood cells become rigid and shaped like crescent moons or sickles. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled.
Brittany Long - YouTube faces scale. VSim Brittany Long Pre/Post test. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis.
Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex doses.
care professional if symptoms persist or worsen. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. She has had 9:31 You gave the child a sip of juice. Respiration: 25. We have noticed you are logged in to ${country}. hhulsey6.
vSim for Nursing Pediatric | Laerdal Medical Pre/Post Simulation for Brittany Long. PATIENT EDUCATION WHILE TAKING THIS MEDICATION 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. Manage her pain at home with acetaminophen and drink plenty of fluids. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Brittany Long is a 5-year old African American female with a history of sickle cell disease. antipyretics CLASSIFICATION: brought into the emergency department during the night by her mother, who stated that the Blood pressure:riate. Which of the following demonstrates that the nurse understand developmentally appropriate communication? 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I 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.