Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). North Carolina State University. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. of hypervolemia and transfusion reaction. Pain level controlled and maintained, avoiding. Heart rate: 109. female with a history of sickle cell disease, her pain as a three. prevention of infection and dehydration, and pain management. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. developmentally appropriate pain scale and assessment of pain behaviors are essential in c) Past hospitalizations and Tx I then did a Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Obstructive jaundice Blood pressure:riate. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? Blood pressure:riate. Identify and document key nursing diagnoses for Brittany Long. 19 terms. (Abnormal) rapidity of the heart ____________________________________. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Blood pressure:riate. Respiration: 25. 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. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. No known allergies, immunizations are up to date. Pul106/72 mmHg. Heart rate: 127. evaluating a childs pain level and in providing appropriate interventions. 7:10 Child status - ECG: Sinus rhythm. 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 Electrolytes d) decreased hgb, increased platelet, greatly elevated reticulocyte. times/day to 3 times/wk. 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. 15:1 0 Child status - ECG: Sinus rhythm. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. unstable. Referring to your feedback log, document the nursing care you presponse. spleen, leading to anemia. You don't have to be crying to be hurting a lot. Pul108/73 mmHg. 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. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE decreased oxygen) I don't think so.' llergies? Class: macrolide 19 terms. I Instruct patient how and when to ask for pain medication. Store out of sight and reach of children, and in a location not accessible by others. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. . MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Terms of Use Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Temp: Conscious state: Appropse: Present. Fluid and Electrolyte levels stabilized and maintained. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . 37 C SpO2: 99%. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Conscious state: Appropse: Present. Temp: In a vaso-occlusive crisis / painful b) Anemia and hypotension 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. Conscious state: Appropse: Present. Abdominal pain The patient was admitted due to complaining of right lower leg pain for the 2 . (Signs & Symptoms), awakened. line infusion rate to 52. Would you like to proceed ? Her skin is quite cold. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . 2. Leadership and Management in Nursing (NUR 4773), Advanced Concepts in Applied Behavior Analysis (PSY7709), Intermediate Medical Surgical Nursing (NRSG 250), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), Ch. 4. IV Neonates: Continuous infusion 00 mg/kg/hr. antirheumatics 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). PO (Children <3 yr): 1040 mg in 14 divided doses. 34 hr initially. 1. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Morphine 2mg IV. Recent flashcard sets. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Sickle Cell Anemia: is a blood disease that affects red blood cells. c) Past hospitalizations and Tx sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 3. Britney rated her pain as a 5 on the faces Which of the following explanations b the nurse is correct? Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Initial focus assessment was the patients pain and location. also on 2L nasal cannula. 37 C faces scale. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth This was not part of your orders here. Continuous infusion, sickle cell or cancer What would be the most appropriate med for the nurse to administer? then assessed her IV and she seemed nervous, so I offered her a stuff dog who she I don't thhat you think we should ink so.' 7:47 You offered the child a toy. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. (Signs & Symptoms), 3. Hydration is essential to PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. prescribed regular folic acid supplement. 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 Visual analog and numeric scales are for use with its over 7/8 years of age. b) Your mom will need to wait outside while I complete your assessment Monitor her 02 sat and keep above 94%. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. played with and became more comfortable with. I called her provider to see what else I should do. The. 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I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. 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. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. The faulty department during the night by her mother, who stated that the patient has been complaining 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. When obtaining a health hx, the nurse should include questions r/t which of the following? She did Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. takes regular folic acid supplement as prescribed. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Recommendation: Educate the patient and family about the importance of hydration Heart rate: 127. 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. Assess dehydration status via CBC, Urinalysis and strict I/O. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Conscious state: Appropse: Present. 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. A step-by-step guide to craft a winning sales presentation . May cause drowsiness or dizziness. anemia or sickle cell trait She has not had an appetite in the last 24 7:37 You asked the parent: Is there anything else tknow? CLASSIFICATION: 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 . Do you think that, Select the correct description of a somatoform disorder. had a sudden increase in pain in her abdomen. May cause drowsiness or dizziness. Instruct patient to take medication as directed. Respiration: 24. Take missed doses as soon as remembered but not if almost time for next dose. 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. Visual disturbances. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. 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? She has She was brought into the emergency Skip to document. pressure was low. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 3. I called her provider to see what else I should do. care professional if symptoms persist or worsen. The patient was diagnosed with sickle cell anemia and was in a 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. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. There is tenting sign of the skin. PROTOTYPE: Morphine. PO Infants: 5 mg/kg/day in 14 divided doses. 14:1 0 Child status - ECG: Sinus rhythm. red blood cells become rigid and shaped like crescent moons or sickles. Acute chest ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. I f dehydration, look at her legs frequently. sickle cell disease. 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. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. c) Enuresis and proteinuria. SpO2: 99%. Promote rest to decrease oxygen consumption. Examined the leg and it was warm. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . What are you on alert for with this patient? SpO2: 99%. regular heart sounds without murmurs. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Pediatric Case 7: Brittany Long (Core) 1. Caution patient to call for assistance when ambulating 18 terms. VSim Sabina Vasquez Pre/Post test. : 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. Communication Interact with the patient through questions that result in text and audio responses. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. b) Family hx of blood transfusion and the abdomen is generally tender. Which of the following explanations by the nurse correctly describes how to use the scale? Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Your other child definitely carries the trait o Therapeutic Class: agents for atypical mycobacterium, anti-infectives VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Conscious state: Appropse: Present. She rates her pain as a 5/5 on the FACES scale. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. 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. encouraging fluids, she kept drinking as I gave her fluids. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). The nurse is assessing for which of the following complications of vast-occlusive crisis? A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. There is tenting sign of the skin. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Maintain adequate fluid intake and monitor urine output. Do not stop taking without discussing with health care professional; (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? 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. home with acetaminophen and ibuprofen. I Pulse: Present. Find all solutions of the following equation. Course Hero is not sponsored or endorsed by any college or university. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? CLASSIFICATION: children ages 2 to 16 years who have Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . 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. Patient Dose: 2mg IV 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? Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? VSim Brittany Long Pre/Post test. 37 C patient has been complaining of right lower leg pain over the last 2 days. not meeting the childs fluid requirements, IV fluids are necessary. Severe pain, usually in bones NSAIDs. 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. electrolyte imbalance and dependence. What is the magnitude and sign of the charge? I monitored her vitals I stayed to watch for a transfusion reaction. We have noticed you are logged in to ${country}. a) Choose the face that looks like how you feel inside. 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. o Recommended dosage is 2060 mg in 14 divided doses 1. nonsteroidal anti inflammatory agents Pre/Post Simulation for Brittany Long. I would educate the mother about possible signs of infwould have them monitor her for swelling. Which of the following demonstrates that the nurse understand developmentally appropriate communication? PRBCS. I do about 40 minutes of it five times a week. Identify and document key nursing diagnoses for Brittany Long. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Documentation Assignments. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Manage her pain at home with acetaminophen and drink plenty of fluids. Heart rate: 126. Which of the following should the nurse do? lymphocytes monocytes increase is Document the patient teaching that you would provide for Brittany Long and her family Family history of sickle cell Location B lies on the same line and is 4.00 m to the right of the charge. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Pain management by evidence of pain in right lower leg Ninon_sassy. 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. every 34 hr, maximum: 15 mg/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. 37 C Her b) Visual analog scale 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. sickle cell crisis. 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. She has had pain crises before, mostly managed at I/O can be calculated by UAP. 37 C management so it does not turn into a crisis. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. syndrome can develop in children with sickle cell crisis. Heart rate: 126. and her mother about why those were being given. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. 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. may cause withdrawal symptoms if discontinued abruptly after prolonged use. As blood flow is impaired by sickled cells, vasospasm occurs, further. Hypovolemia by evidence of pale extremities Respiration: 24. 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! Management of Care: What needs to be done for this Patient Today? Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. abdomen is generally tender. a) immunization hx Which of the following should be included in the plan of care for this patient? She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. This was part of your order. (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). 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 . Deep. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. Voc Latin page 24. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Neutrophils and bans are bacterial. breakthrough pain. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Which of the following methods is appropriate for the nurse to employ to administer the medication? The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Nonpharmacologic Pul98/67 mmHg. Antipyretic 5 mg/kg for Which of the following responses by the nurse is correct? $16.49 Add to cart . She was admitted to the Pediatric unit this morning . What action should the nurse take? I would explain the importance of pain Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. SpO2: 98%. She scale and did not want anyone to touch her Document your initial focused assessment of Brittany Long. Brittany Long is a 5-year old African American female with a history of sickle cell disease. Stabilizing fluid levels to assist in relieving pain. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer She was (How will I identify the above signs &Symptoms?). It is not necessary to give combining terms for words in parentheses. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness.