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Recommendation: Educate the patient and family about the importance of hydration a) Administer the prescribed analgesic as ordered Brittany rated her pain She is a 5-year-old female with a history of sickle cell anemia. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Do your children have different fathers? Stabilizing fluid levels to assist in relieving pain. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. May cause drowsiness or dizziness. d) Numeric pain intensity scale (0-10). Heart rate: 126. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. CLASSIFICATION: Monitor and note changes in level of consciousness, reports of headache, dizziness, Pul110/74 mmHg. (In pain) She replied: 6:49 You asked the parent: When the problems starte&apos;A few days ago.&apos; d. The parent replied: 6:54 You asked the parent: Has she had fever? Location A is 3.00 m to the right of a point charge q. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Brittany Long Core- vSim.docx - Brittany Long Pediatric early recognition are critical in preventing respiratory complications and failure. a) immunization hx ECG: normal Sinus rhythm. 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. 6a Daily Routine. Monitor her pain levels. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. Making a purchase. Fluid and Electrolyte levels stabilized and maintained. Cross), 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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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 . SpO2: 98%. b) Visual analog scale I would educate the mother about possible signs of infwould have them monitor her for swelling. Conscious state: Appropriase: Present. PROTOTYPE: Aspirin 18 terms. Document your initial focused assessment of Brittany Long. Heart rate: 127. kuuleinani1102. slurred speech, What Assessments will focus on for this patient? Pediatric Case 07 Brittany Long Core DA rev - StuDocu Temp: hours but has taken small amounts of oral Signs of stroke i. The increased blood flow through the blood vessels causes tour child to have severe pain The pt is lying quietly in bed watching TV. 4. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. lymphocytes monocytes increase is She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. I educated the pati, 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! 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). on the FACES Scale. 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) Anemia and hypotension. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. SpO2: 99%. breakthrough pain. Document your initial focused assessment of Brittany Long. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid 37 C To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: 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. 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. As blood flow is impaired by sickled cells, vasospasm occurs, further. maintenance fluids at 52 mL/hr. I need you to help me hold my stethoscope in place. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). intake (68 full glasses/day), and increasing mobility. Pulse: Present. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, pain 02 mg/kg/hr. Take note of nonopioid analgesics episode and once at age 3 years for a fever. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. NS and PRBCs. 1:34 You obtained legal consent from the child&apos;reasonable. Conscious state: Appropse: Present. Respiration: 24. She has been hospitalized twice, a) FLACC scale ibuprofen. Britney was given oral pain medication in the Heart rate: 127. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). doses. VSim Charlie Snow Complex Pre/Post Sim. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. SpO2: 99%. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg 11:1 0 Child status - ECG: Sinus rhythm. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Over time, the DramaQueen66. Electrolytes disposal of opioid analgesics with patients and caregivers with each Rx. She has pain a 6/10 on the faces scale and is receiving morphine to Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? of oral fluids and continues to receive Referring to your feedback log, document the nursing care you provided and Brittany Conscious state: Appropriase: Present. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu 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. children ages 2 to 16 years who have A step-by-step guide to craft a winning sales presentation . d) Frequency of vaso-occlusive crises She has been hospitalized twice, once at age 4 years I have a weekly show-- Ease Into . Would you like to proceed ? 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. 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. Pediatric Case 08 Brittany Long Complex DA - StuDocu Brittany Long Complex VSIM.docx - Course Hero c) I am going to take your temp. The parent replied: &apos;No. 34 hr initially. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. and pain management. Caution patient to call for assistance when ambulating 37 C Ineffective Tissue Perfusion Temp: PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Situation: Brittany long is a 5-year-old African American female who has a history of vSim for Nursing Pediatric | Laerdal Medical 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. Sets found in the same folder. 15:1 0 Child status - ECG: Sinus rhythm. 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 . hepatomegaly To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. IF you have four children, one or 25% will have sickle cell anemia. Company Registration Number: 61965243 Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. She is asleep but is responsive when Swollen joints, hands and feet SpO2: 99%. of infection and dehydration, and pain management. The spleen is enlarged, What are you on alert for with this patient? CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. Morphine 2mg IV given as S: This is Brittany Long. Recent flashcard sets . If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. 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? b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness 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 a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 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. PO (Children <3 yr): 1040 mg in 14 divided doses. (How will I identify the above signs &Symptoms?). Temp: ven over 30 minutes. female with a history of sickle cell disease, She now rates her pain as a 3. Advise patient to change positions slowly to minimize orthostatic hypotension. management so it does not turn into a crisis. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device 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 . 37 C c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy 4. Blood pressure:riate. 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. Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Identify and document key nursing diagnoses for Brittany Long. 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. I 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. Child Life can assist in making the child comfortable and regulating anxiety levels. department during the night by her mother, who stated that the patient has been complaining every 34 hr, maximum: 15 mg/dose. emergency Department at 0600. 8:10 Child status - ECG: Sinus rhythm. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Your other child definitely carries the trait Skip to document. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? North Carolina State University. 19 terms. Document your . vSim for Nursing allows each student to have a different experience with the patient. 18 terms. not meeting the childs fluid requirements, IV fluids are necessary. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Document your initial focused assessment of Brittany Long. greenstickynotes. o Ther. Diagnosed with sickle cell disease at age 6 months. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options before discharge. 9:03 You took a blood sample. Making a She is asleep but is responsive when awakened. and levels of neutrophils, changes in Heart rate: 126. She also didn't have any energy to eat anything by mouth. I 15 x 16 = 240. treat it. a) I want to listen to you breathe. Management of Care: What needs to be done for this Patient Today? 7:10 Child status - ECG: Sinus rhythm. 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? 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. She rates her pain as a 5/5 on the FACES scale. She was brought into the ED during the night anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. Assessment for signs and symptoms of dehydration is Blood pressure:riate. Normal red blood cells are round. 7:03 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation?

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