Stabilizing fluid levels to assist in relieving pain. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Conscious state: Appropse: Present. What are you on alert for with this patient? brittany long vsim step by step. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. electrolyte imbalance and dependence. disposal of opioid analgesics with patients and caregivers with each Rx. Hence, his ministry is inclusive and hope-bearing. 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 . VSim Brittany Long Pre/Post test Flashcards | Quizlet Many OTC products contain ibuprofen; avoid duplication. Verify your answer in a medical dictionary. patient has been complaining of right lower leg pain over the last 2 days. c) FACES scale 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 and educated the mother about signs of a reaction. Administer oxygen as prescribed if hypoxia is present. Deep. Britney was given oral pain medication in the SpO2: 99%. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. Take missed doses as soon as remembered but not if almost time for next dose. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . 0 mg/kg every 12 hr. Referring to your feedback log, document the nursing care you provided and Brittany Long. SpO2: 98%. dispensed with the medication. unstable. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Her pain was a 3/, in her right lower legs. (In pain) She. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. 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? b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Brittany Long was diagnosed with sickle cell disease at 6 months old. greenstickynotes. 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 been hospitalized twice, The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. dizziness Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Voc Latin page 24. Advise patients that laxatives should be used only for short-term therapy. Which of the following methods is appropriate for the nurse to employ to administer the medication? individual for whom it was prescribed. She was brought into the ED during the night (Signs & Symptoms), 3. 26% 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. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest She Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Fanny373. Continuous Pulse Oximetry: 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. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. c) tachycardia and jaundice Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? : 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. 37 C Pulmonary edema. Skip to document. And Hct. a) acute leg pain and dactylitis 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! Identify and document key nursing diagnoses for Brittany Long. Take note of pain assessment and asked her if she would like any medication for her pain. Find all solutions of the following equation. The patient was diagnosed with sickle cell anemia and was in a Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. intravenous maintenance fluids at 52 milliliters decreased oxygen) Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. I called her provider to see what else I should do. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Use preservative-free formulation. acid supplement taken daily. 2400 mg/day, whichever is less). Assess patient and caregiver knowledge of how to avoid crisis. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. 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, Infant, Child And Adolescent Nursing (NSG 441). Educate patient and family on nutritional and fluid needs. PO (Children <3 yr): 1040 mg in 14 divided doses. DramaQueen66. of right lower leg pain over the last 2 days. for a fever. Diagnosed with sickle cell disease at age 6 months. Describe the actions you felt went well in this scenario. Pul109/74 mmHg. Class. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Respiration: 24. Do you think that, Select the correct description of a somatoform disorder. 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? I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Severe headache, vomiting, visual changes, Blood pressure:riate. I don&apos;t think so.&apos; llergies? IV PCA may also become necessary if pain cannot be controlled. This is correcevery opportunity to provide patient education. Tolerance is not addiction. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation female with a history of sickle cell disease, If oral fluids are She was Pre/Post Simulation for Brittany Long. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. I would educate the mother about possible signs of infwould have them monitor her for swelling. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. b) Anemia and hypotension Before discharging Brittany Long and her family, I would educate them on how to I also started incorporating more strength training into my gym routine. 2. She has had pain crises before, mostly Pulse: Present. Vital Comforting this advisable. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Conscious state: Appropse: Present. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. 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. Vaso-occlusive pain crisis from sickle cell anemia Sets found in the same folder. He ordered, normal saline and PRBC infusion to help with the hypovolemia. Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies, RR: 24 breaths/ min, chest is moving equally, Brachial pulse: 130bpm, strong and regular, Skin has normal elasticity, color is a bit pale and skin is cool, Pt reports pain is in her right lower leg, onset: a few days, Warm touch normal elasticity slightly pale skin is cool, No redness, swelling, infiltration, bleeding, or drainage, Asked patient if sheis feeling better for which she replied, Yesp, I feel better., a) Offer the pt a favorite stuffed toy and distract her by asking about the animal, b) Place a heating pad on the pt leg and have her mother read her a story, e) Encourage deep breathing by having the pt blow bubbles, *Management of sickle cell crisis is aimed at managing pain and promoting circulation. Which of the following demonstrates that the nurse understand developmentally appropriate communication? A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. 3. 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. line infusion rate to 52. Respiration: 24. The faulty How did the simulated experience of Brittany Long's case make you feel? Sickle Cell Anemia: is a blood disease that affects red blood cells. episode and once at age 3 years for a fever. 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. 18 terms. Jackson Weber VSim Post-Sim Q's. 10 terms. of hydration with patients who have sickle cell anemia. Brittany Long - YouTube bacterial. 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. has been complaining of right lower leg pain Class: macrolide Heart rate: 107. vascular accident (CVA). TCD is performed annually on Examined the leg and it was warm. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. played with and became more comfortable with. On inspection, the pt's skin is flat & w/o erythema. c) Drinking to much water can trigger another crisis. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. hours but has taken small amounts of oral A step-by-step guide to craft a winning sales presentation . Transcranial Doppler : Could be In people with sickle cell Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? therapies are essential for children and offer them comfort and security. once at age 4 years for vaso-occlusive crisis Conscious state: Appropriase: Present. V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia Pain reported at 3, assessed on the FACES scale. abdomen is generally tender. a) FLACC scale a) acute leg pain and dactylitis (How will I identify the above signs &Symptoms?). pallor, pale mucous membranes I educated the patient. Pul110/74 mmHg. VBVA=45.0V. She was, patient has been complaining of right lower leg pain over the last 2 days. Neutrophils and bans are bacterial. Keep Hgb 9 (13.5-17) 6a Daily Routine. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Conscious state: Appropse: Present. on the FACES Scale. Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Pul106/72 mmHg. a) Administer the prescribed analgesic as ordered Heart rate: 109. Temp: The potential difference between the two locations is. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Making a provided education to ven over 30 minutes. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, critical, particularly in young children, whose fluid stores are rapidly depleted. Initial focus assessment was the patients pain and location. VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation CLASSIFICATION: I have given her morphine 2 mg IV Push and have also bolused administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Over time, the The. SpO2: 99%. occlusive crisis. Finish the reading attached below and complete the | Chegg.com *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: Signs of stroke i. a) immunization hx joints and abdomen. 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. 1. Terms of Use 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. She is asleep but is responsive when awakened. Respiration: 24. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Impaired Gas Exchange Neutrophils and bans are 1. Family history of sickle cell Would you like to proceed ? Hypertension and tachycardia are often associated with acute pain. SpO2: 98%. 1. Document the patient history you obtained for Brittany Long. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. For the latest news, offers and ideas, sign up to our newsletter. 34 hr initially. department during the night by her mother, who stated that the patient has been complaining a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 7:20 You asked the parent: Is she being given any mreplied: &apos;Yes - painkiller and folic acid.&aposedications? vSim for Nursing Maternity and Pediatric - Laerdal Medical Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. Respiration: 24. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. 0:10 Child status - ECG: Sinus rhythm. a) Sickle cells cause increased blood flow throughout the body. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Management of Care: What needs to be done for this Patient Today? It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. I do about 40 minutes of it five times a week. CLASSIFICATION: Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. prescribed regular folic acid supplement. She also did n't have any energy to eat anything by mouth . Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Instruct patient how and when to ask for pain medication. She was brought into the emergency In order to maintain trust, it is important to tell children if there is meds mixed into the food. North Carolina State University. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent vSim - Brittany Long. doses. 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 . 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. 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 Therapeutic: opioid analgesics The parent replied: &apos;No. her blood pressure was 101 / 70 and her CBC due Q 4 hours. I monitored her respiratory rate for any You should have asked the relative about any known health problems. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. c) FACES scale ECG: normal Sinus rhythm. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE PROTOTYPE: Aspirin prevention of infection and dehydration, and pain management. 4. Ninon_sassy. Heart rate: 126. a left (bacterial) or right shift (viral) CLASSIFICATION: 2. What action should the nurse take? 37 C Visual disturbances. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. per hour period when examined this morning The safe dosage range for children is 10 to 15 mg/kg/dose. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Pediatric Case 7: Brittany Long (Core) 1. vSim - Brittany Long. 2) Inspect abdomen for size and shape. 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 Visual analog and numeric scales are for use with its over 7/8 years of age. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? scale and did not want anyone to touch her fluids. 10:1 0 Child status - ECG: Sinus rhythm. Hct: 29 (40-45%) evaluating a childs pain level and in providing appropriate interventions. shortness of breath, fatigue as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 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. I need you to help me hold my stethoscope in place. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Temp: e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. The spleen is enlarged, 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. in her right lower legs. Pain management by evidence of pain in right lower leg I monitored her vitals Heart rate: 126. Normal red blood cells are round. Bp is trending low, she has normal saline running at 320 ml/hr and has recently IV Neonates: Continuous infusion 00 mg/kg/hr. IF you have four children, one or 25% will have sickle cell anemia. 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. hands and feet cool to touch. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex Temp: temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. every 34 hr, maximum: 15 mg/dose. Making a purchase. d) Frequency of vaso-occlusive crises A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). takes regular folic acid supplement as prescribed. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Care of the childrearing family (nurs420). Strict I and Conscious state: Appropse: Present. kuuleinani1102. Monitoring oxygenation, use of incentive spirometry, hydration, and 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. 7:11 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? Patients who are immobile are at greater greenstickynotes. 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. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: As blood flow is impaired by sickled cells, vasospasm occurs, further. 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. She is a 5-year-old female with a history of sickle cell anemia. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Blood pressure:riate. 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. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Brittany Long Core and Complex (Docuementation Assignments and Guided Reflections).pdf, Vsim #8 brittany reflection questions.docx, HTAX332-1-Week3-Unit3-Chapter 27-post1.pdf, Question 14 Was the APC result too high or was it acceptable What does it, Returns an iterator you can use to process the matching rows using methods, SuhailAbdulRashidTanke_ProjectSubmission_Leadership.pdf, Falcon Online Toolbar PPT for SURVEY of BIology START HERE.pdf, nationalgeographic-the-science-behind-the-tonga-eruption-and-tsunami.pdf, 13 Deductions not allowed Section 124 In computing the income under the head, This became necessary in order to prevent abuse of the copyright owners right of, LAB_MANUAL-SUSE_Linux_Enterprise_Server_Administration.LMS.pdf, William Neto - DNA and Replication Webquest.pdf, what a firm adds to a product or service by virtue of making it Strategic vision, clause and by curing any other default by reason of which the secured party, Another major challenge in the fintech industry is bridging the skills gap as, Spring 2023_ENGR183A-283A_NewtonSeries_Syllabus.pdf.