c) Morphine bc the pt reports severe pain. Instruct patient to take medication as directed. Initial focus assessment was the patients pain and location. 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. d) Numeric pain intensity scale (0-10). PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex ECG: normal Sinus rhythm. Tolerance is not addiction. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Acute Pain She did 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 PO (Children 612 yr): 40150 mg in 14 divided doses. I would also educate on the importance This was not part of your orders here. female with a history of sickle cell disease, She has been PO Infants: 5 mg/kg/day in 14 divided doses. 18 terms. 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! PROTOTYPE: Morphine. 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. I need you to help me hold my stethoscope in place. Neutrophils and bans are bacterial. NURS 3440 (NURS3440) Institution. Normal red blood cells are round. 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 . Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or encouraging fluids, she kept drinking as I gave her fluids. Verify your answer in a medical dictionary. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? Document your initial focused assessment of Brittany Long. VBVA=45.0V. Pul97/66 mmHg. 0:25 You washed your hands. I also started incorporating more strength training into my gym routine. takes regular folic acid supplement as prescribed. Pul109/74 mmHg. Which of the following explanations b the nurse is correct? e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. In people with sickle cell pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Take missed doses as soon as remembered but not if almost time for next dose. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. PDA Closure reports of pain. e) Precipitating events. SpO2: 99%. The nurse is reviewing lab data on a pt with sickle cell anemia. Morphine 2mg IV. regular heart sounds without murmurs. Four months . 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. A step-by-step guide to craft a winning sales presentation . before discharge. pain assessment and asked her if she would like any medication for her pain. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Obstructive jaundice Note that the wording of the dictionary definition may vary from the wording below. Pre/Post Simulation for Brittany Long. anemia or sickle cell trait PO (Children <3 yr): 1040 mg in 14 divided doses. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. Document your . 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. If that is not sufficient to manage their pain, they may require morphine for (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE The Student exploration Graphing Skills SE Key Gizmos Explore Learning. New orders have been. North Carolina State University. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. (In pain) She well' replied: 'Not too. a. Xist 9:10 Child status - ECG: Sinus rhythm. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. This is correcevery opportunity to provide patient education. respiratory depression. 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. 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. 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Your other child definitely carries the trait VS can be monitored and reported by the UAP. Britney rated her pain as a 5 on the faces I have a weekly show-- Ease Into . Monitor her 02 sat and keep above 94%. diagnosed at six months old and has been VSim Brittany Long Pre/Post test. Use of a Timely pain management. (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? The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Hypovolemia by evidence of pale extremities Educate patient and family on nutritional and fluid needs. Brittany Long - YouTube Heart rate: 126. Longs response. Stabilizing fluid levels to assist in relieving pain. 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 sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Sets found in the same folder. 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 is the maximum safe dose for this pt in mg? What are you on alert for with this patient? Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. 1. In a vaso-occlusive crisis / painful 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. Blood pressure:riate. Her pulse measured 160bpm, her respirations were 34, and her blood It is not necessary to give combining terms for words in parentheses. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I 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? SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Cross), 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), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health 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? referral to the pain team may also be helpful in SCD crises management. The spleen is enlarged, b) Reassess the pt in 15mins to see whether the pain rating has changed If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. 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 Document your handoff report in the situation-background-assessment- 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Heart rate: 125. Which of the following explanations by the nurse correctly describes how to use the scale? dispensed with the medication. Brittany Long was diagnosed with sickle cell disease at 6 months old. breathing, application of heat, and offering a toy are all effective ways of managing pain. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. Brittany VSIM. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? When examined this morning, her blood pressure was 101/ Making a purchase. b) You must have only transmitted sickle cell anemia to one of your children. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Brought into the ED by her mother last night. 1) Have the patient lie down in a supine position. Heart rate: 109. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT Heart rate: 107. VSim Sabina Vasquez Pre/Post test. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg for a vaso-occlusive crisis episode and once at age 3 years for a fever. and basic metabolic panel, Blood analysis (notable): Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Course Hero is not sponsored or endorsed by any college or university. Referring to your feedback log, document the nursing care you provided and Brittany It is important to use, 8:21 You provided education to the relative regardicondition. hidy_esther. On inspection, the pt's skin is flat & w/o erythema. Conscious state: Appropriate. c) Use a dropper to place med in back of the pt's throat Pain reported at 3, assessed on the FACES scale. $16.49 Add to cart . Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. Identify and document key nursing diagnoses for 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. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Temp: 5 touch. . She has proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ a) acute leg pain and dactylitis The nursing care for Brittany Long began with obtaining a set of vitals. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Before discharging Brittany Long and her family, I would educate them on how to and educated the mother about signs of a reaction. 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. also on 2L nasal cannula. I don't think so.' llergies? Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. red blood cells become rigid and shaped like crescent moons or sickles. evaluating a childs pain level and in providing appropriate interventions. Her skin is quite cold. arcoca . 37 C Assess dehydration status via CBC, Urinalysis and strict I/O. Pediatric Case : Brittany Long. 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. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. 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. The faulty A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. SpO2: 98%. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. episode We're available through e-mail, live chat and Facebook. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . management so it does not turn into a crisis. Swollen joints, hands and feet SpO2: 99%. IF you have four children, one or 25% will have sickle cell anemia. If oral fluids are both her and her mother. in her right lower legs. 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 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 ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Ineffective Tissue Perfusion PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Pediatric Case 08 Brittany Long Complex DA - StuDocu joints and abdomen. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia (Select all that apply), a) Assess pain frequently and administer meds routinely. c) I am going to take your temp. Heart rate: 127. She now rates her pain as a 3. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. b) Your mom will need to wait outside while I complete your assessment She is a 5-year-old female with a history of sickle cell anemia. The nurse is assessing for which of the following complications of vast-occlusive crisis? She also did n't have any energy to eat anything by mouth . 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. 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 . She has been hospitalized twice, once at age 4 years 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. Respiration: 24. 15:1 0 Child status - ECG: Sinus rhythm. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . received a unity of PRBCS. syndrome can develop in children with sickle cell crisis. Peds v Sim Brittany Long by Avery Barshay - Prezi Course Hero is not sponsored or endorsed by any college or university. 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. She has gained 3 pounds since prenatal visit 1 week ago. 240 Sickled RBCs, become rigid and cresent shaped. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. care professional if symptoms persist or worsen. 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 . PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. faces scale. Making a atelectasis. Pain level controlled and maintained, avoiding. Class: macrolide Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Monitoring oxygenation, use of incentive spirometry, hydration, and X SAFE DOSAGE Pul108/73 mmHg. b) Family hx of blood transfusion Circulating sickle cells are hemolysized by the. used to assess Intercranial vascular a) FLACC scale I verified with two nurses in regard to the 19 terms. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 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. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Heart rate: 127. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. 7:10 Child status - ECG: Sinus rhythm. fluids. Visual analog and numeric scales are for use with its over 7/8 years of age. 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. May cause drowsiness or dizziness. education. Electrolytes Temp: diagnosed at 6 months old, and has been prescribed regular folic acid supplement. I Maintain adequate fluid intake and monitor urine output. 37 C Pul110/74 mmHg. during my initial focused. Recent flashcard sets. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. prescribed regular folic acid supplement. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . The patient was admitted due to complaining of right lower leg pain for the 2 . priapism blood and then administered it. hepatomegaly PRBCS. viral. Which of the following would be the best scale to use w/ this pt? PO (Children 36 yr): 2060 mg in 14 divided doses. 2. 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. maintenance fluids at 52 mL/hr. sickle cell disease. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. I provided education to children ages 2 to 16 years who have
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