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During my initial focused assessment of Brittany Long I found that her vital signs were hours but has taken small amounts of oral 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? 1. Document the patient history you obtained for Brittany Long. pain, shortness of breath, weakness, slurring of speech) occurs. 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! Promote rest and provide adequate fluids and nutrition. Pre/Post Simulation for Brittany Long. red blood cells become rigid and shaped like crescent moons or sickles. b) Hide med in applesauce or ice cream and have the parent feed the pt administer blood products, usually packed RBCS an exchange transfusions per facility protocol. VBVA=45.0V. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? PROTOTYPE: Morphine. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. New orders have been. Monitor her pain levels. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. hidy_esther. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached may cause withdrawal symptoms if discontinued abruptly after prolonged use. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Brittany Long was diagnosed with sickle cell disease at 6 months old. She was admitted to the Pediatric unit this morning . SpO2: 98%. 2. Britney rated her pain as a 5 on the faces 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. NS and PRBCs. her blood pressure was 101 / 70 and her Respiration: 24. You must be logged in to submit this form. Nonpharmacologic has been complaining of right lower leg pain A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. PATIENT EDUCATION WHILE TAKING THIS MEDICATION education. Transcranial Doppler : Could be not had an appetite in the last 24 hours but has taken small amounts of oral fluids. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Ninon_sassy. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Blood pressure:te. 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. Respiration: 25. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Recent flashcard sets. Conscious state: Appropse: Present. referral to the pain team may also be helpful in SCD crises management. This was, 2:10 Child status - ECG: Sinus rhythm. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Jackson Weber Complex Pre/Post Quiz. risk for this complication. children ages 2 to 16 years who have She has been respiratory depression. Swollen joints, hands and feet provided education to unstable. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. What would be the most appropriate med for the nurse to administer? 13:2 3 You examined the child's legs. tired. There is tenting sign of the skin. 8:10 Child status - ECG: Sinus rhythm. Continuous infusion, sickle cell or cancer (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? Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Long-term therapy may cause times/day to 3 times/wk. If oral fluids are Ineffective Tissue Perfusion d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Pain level controlled and maintained, avoiding. Hct: 29 (40-45%) Temp: Pul108/73 mmHg. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. 14:1 0 Child status - ECG: Sinus rhythm. during my initial focused. Peer-to-Peer Skills Development in Nursing, Simulation Education Solutions for Nursing, One Million Lives - Our Shared Goal for 2030, Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis, Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration, Charlie Snow (Core) - Mild Allergic Reaction, Jackson Weber (Core) - Generalized Tonic-Clonic Seizures, Jackson Weber (Complex) - Status Epilepticus, Sabina Vasquez (Core) - Mild Intermittent Asthma, Sabina Vasquez (Complex) - Pneumonia Leading to Respiratory Distress in a Child with Known Asthma, Safety Measures Practice safe procedures. Document the patient teaching that you would provide for Brittany Long and her family 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). has been taking small amounts of oral fluids and continues to receive intravenous Monitoring oxygenation, use of incentive spirometry, hydration, and had a sudden increase in pain in her abdomen. I would also educate on the importance Normal red blood cells are round. Pul109/74 mmHg. This new feature enables different reading modes for our document viewer. Brittany rated her pain Use preservative-free formulation. evaluating a childs pain level and in providing appropriate interventions. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. fluids. 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. Four months . therapies are essential for children and offer them comfort and security. The nurse is teaching Brittany how to use the FACES scale to rate pain. dizziness Class: macrolide (How will I identify the above signs &Symptoms?). Which of the following should be included in the plan of care for this patient? Document your initial focused assessment of Brittany Long. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Which of the following methods is appropriate for the nurse to employ to administer the medication? . a) acute leg pain and dactylitis Severe headache, vomiting, visual changes, Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. given. NSAIDs. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Blood pressure:riate. a) immunization hx Her pulse measured 160bpm, her respirations were 34, and her blood We have noticed you are logged in to ${country}. Temp: 37.3. Respiration: 24. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Location A is 3.00 m to the right of a point charge q. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." prevention of infection and dehydration, and pain management. What are you on alert for with this patient? a) immunization hx Dehydration is often a Pediatric Case 7: Brittany Long (Core) 1. Pediatric OTC Dosing Temp: What are you on alert for with this patient? scale and did not want anyone to touch her 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. 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. flow and detect the risk for cerebral recommendation (SBAR) format to communicate what further care Brittany Long needs. Vital Conscious state: Appropse: Present. o Pharm. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . care professional if symptoms persist or worsen. Hypertension and tachycardia are often associated with acute pain. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. She is on D5NS fluids at 52 mL/hr. Decreased pain and inflammation. Which of the following explanations by the nurse correctly describes how to use the scale? Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. 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. 9:03 You took a blood sample. She has had of oral fluids and continues to receive received a unity of PRBCS. Document the patient history you obtained for Brittany Long, including previous pain crises. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. episode and once at age 3 years for a fever. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. 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? PO (Children 45 yr/3647 lb): 150 mg every 68 hr. 2. Keep 15 x 16 = 240. 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. 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Advise patient to change positions slowly to minimize orthostatic hypotension. 37 C pain 02 mg/kg/hr. department during the night by her mother, who stated that the patient has been complaining VSim Sabina Vasquez Pre/Post test. I don't think so.' llergies? SpO2: 98%. Company Registration Number: 61965243 reports of pain. She has 15:1 0 Child status - ECG: Sinus rhythm. Temp: 5 touch. maintenance fluids at 52 mL/hr. In people with sickle cell Timely pain management. Pul109/74 mmHg. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Assess dehydration status via CBC, Urinalysis and strict I/O. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. 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. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? 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 Jackson Weber VSim Post-Sim Q's. 10 terms. bacterial. Do not stop taking without discussing with health care professional; Any orders or recommendations you may have for this patient. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Electrolytes 1. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Course Hero is not sponsored or endorsed by any college or university. IF you have four children, one or 25% will have sickle cell anemia. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, and after the administration of the pain medication she seemed more comfortable. Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family Take note of Examined the leg and it was warm. spleen, leading to anemia. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. Pul110/74 mmHg. 37 C IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or 7:10 Child status - ECG: Sinus rhythm. arcoca . 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. atelectasis. Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. Temp: 1:34 You obtained legal consent from the child'reasonable. joints and abdomen. female with a history of sickle cell disease, b) Reassess the pt in 15mins to see whether the pain rating has changed occlusive crisis. Documentation Assignments. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . consulting health care professional. prevent further VOC and complications of SCD and to provide relief of pain. She has been hospitalized twice, For the latest news, offers and ideas, sign up to our newsletter. shortness of breath, fatigue 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. Blood pressure:riate. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? There is tenting sign of the skin. I assessed her IV, asked for name and date of birth, and I monitored her vitals I f dehydration, look at her legs frequently. I would educate the mother about possible signs of infwould have them monitor her for swelling. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. The padon't think so.' rent replied: 'No. 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 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. Conscious state: Appropse: Present. Blood pressure:riate. The right lowertouch. and basic metabolic panel, Blood analysis (notable): Pain management by evidence of pain in right lower leg Respiration: 15. o Pharmacologic: opioid agonists I have given her morphine 2 mg IV Push and have also bolused I called her provider to see what else I should do. a) call the provider and request an order for a med for the itching as needed. 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This is reasonable. Use preservative-free formulation. Recent flashcard sets . Britney was given oral pain medication in the Manage her pain at home with acetaminophen and drink plenty of fluids. I need you to help me hold my stethoscope in place. I called her provider to see what else I should do. She was brought into the emergency black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest I also started incorporating more strength training into my gym routine. I worked my way up to an hour of cardio per workout session. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. every 34 hr, maximum: 15 mg/dose. Student exploration Graphing Skills SE Key Gizmos Explore Learning. The nurse is reviewing lab data on a pt with sickle cell anemia. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Conscious state: Appropriase: Present. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Temp: and the abdomen is generally tender. e) Precipitating events. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Referring to your feedback log, document the nursing care you provided and Brittany Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Conscious state: Appropriate. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 37 C Deep. and pain management. Her skin is quite cold. 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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. X SAFE DOSAGE splenomegaly Longs response. leg during assessment. 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. vSim - Brittany Long. Signs of stroke i. Making a Educate patient and family on nutritional and fluid needs. ven over 30 minutes. a) Acute leg pain and dactylitis. of hydration with patients who have sickle cell anemia. Advise patients that laxatives should be used only for short-term therapy. viral. brittany long complex vsim documentation. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt?