This was not part of your orders here. leg is warm to the pain crises before, mostly managed at home with acetaminophen and ibuprofen. provided education to It is not necessary to give combining terms for words in parentheses. 2:49 You identified the child. 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 . Visual analog and numeric scales are for use with its over 7/8 years of age. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? breakthrough pain. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . 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. 2. Temp: NURS 3440 (NURS3440) Institution. She has been Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? determine anemia state & if there is She was brought into the ED during the night Course Hero is not sponsored or endorsed by any college or university. Temp: 37.3. I have given her morphine 2 mg IV Push and have also bolused Pediatric OTC Dosing 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). Monitor O2 saturation levels for a vaso-occlusive crisis episode and once at age 3 years for a fever. hands and feet cool to touch. and basic metabolic panel, Blood analysis (notable): 10:1 0 Child status - ECG: Sinus rhythm. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. red blood cells become rigid and shaped like crescent moons or sickles. She is asleep but is responsive when 240 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. avoid a sickle cell crisis in the future. Blood pressure:riate. I verified with two nurses in regard to the ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Fluid and Electrolyte levels stabilized and maintained. 13 terms. Temp: leg during assessment. Monitoring oxygenation, use of incentive spirometry, hydration, and development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. The safe dosage range for children is 10 to 15 mg/kg/dose. The increased blood flow through the blood vessels causes tour child to have severe pain Diagnosed with sickle cell disease at age 6 months. During my initial focused assessment of Brittany Long I found that her vital signs were He ordered individual for whom it was prescribed. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. hidy_esther. 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? Impaired Gas Exchange Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? female with a history of sickle cell disease, PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Management of Care: What needs to be done for this Patient Today? episode Her pain was a 3/, in her right lower legs. line infusion rate to 52. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. o Therapeutic: opioid analgesics d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Pul110/74 mmHg. PO Infants: 5 mg/kg/day in 14 divided doses. prescribed regular folic acid supplement. department during the night by her mother, who stated that the patient has been complaining Take missed doses as soon as remembered but not if almost time for next dose. of infection and dehydration, and pain management. o Pharm. 7:37 You asked the parent: Is there anything else tknow? SpO2: 98%. d) Numeric pain intensity scale (0-10). She has been hospitalized twice, once at age 4 years VBVA=45.0V. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Conscious state: Appropse: Present. Blood pressure:riate. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Terms of Use a) Place med in an oral syringe and allow the pt to squirt into his or her mouth (Signs & Symptoms), awakened. Hematuria jaundice Pul98/67 mmHg. Use of a vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. shortness of breath, fatigue A step-by-step guide to craft a winning sales presentation . 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. 20 terms. greenstickynotes. 0:10 Child status - ECG: Sinus rhythm. b) Visual analog scale Wolters Kluwer Health. 37 C d) You need to change into hospital gown before I can examine you. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. For the latest news, offers and ideas, sign up to our newsletter. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. And Hct. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. SpO2: 99%. 13:3 9 You phoned the provider in order to discuss the patient. Jackson Weber Complex Pre/Post Quiz. slurred speech, What Assessments will focus on for this patient? On inspection, the pt's skin is flat & w/o erythema. Observe for manifestations 11:1 0 Child status - ECG: Sinus rhythm. I educated the patient. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. CBC w/ dif : SHOULD be ordered to c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy PO (Children 910 yr/6071 lb): 250 mg every 68 hr. 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I would also educate on the importance Temp: prevent further VOC and complications of SCD and to provide relief of pain. VSim Sabina Vasquez Pre/Post test. 2. Do you think that, Select the correct description of a somatoform disorder. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 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. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. PDA Closure Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Advise patient to change positions slowly to minimize orthostatic hypotension. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. 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 . 37 C faces scale. She has 18 terms. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Heart rate: 125. Britney long is a 5 year old African American (In pain) She. 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. Her We're available through e-mail, live chat and Facebook. intake (68 full glasses/day), and increasing mobility. Deep. Sigle prn dose of morphine 2mg was administered. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent 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. Cheever), Pediatric Case 07 Brittany Long Core DA rev, Pediatric Case 04 Sabina Vasquez Complex GRQ, Pediatric Case 04 Sabina Vasquez Complex DA, Managing Engaging Learning Environments (D095), Educational Psychology and Development of Children Adolescents (D094), Success Strategies for Online Learning (SNHU107), Medical/Surgical Nursing Concepts (NUR242), Health-Illness Concepts Across the Lifespan I (NUR 1460C), Concepts Of Maternal-Child Nursing And Families (NUR 4130), Legal Issues in Information Security (C 841), Financial Statement Analysis/Business Valuation (ACC345), Maternity and Pediatric Nursing (NUR 204), 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), A&P II Chapter 21 Circulatory System, Blood Vessels, General Chemistry I - Chapter 1 and 2 Notes, Logica proposicional ejercicios resueltos. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Advise patients that laxatives should be used only for short-term therapy. a) immunization hx emergency Department at 0600. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. nonsteroidal anti inflammatory agents 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. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. a) immunization hx episode and once at age 3 years for a fever. d) Anemia and hypotension. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). She was . Brittany CLASSIFICATION: The child looked slightly c) Past hospitalizations and Tx d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. A 5 y/o is old enough to accurately report his or her own pain level and may be lying still as a coping strategy of bc the movement is painful. Temp: 5 touch. The. 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. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. TCD is performed annually on 3. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. 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. She has been hospitalized twice, Strict I and Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Heart rate: 126. What is the maximum safe dose for this pt in mg? reports of pain. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. vSim - Brittany Long. Which of the following would be the best scale to use w/ this pt? Instruct patient to take medication as directed. Pulmonary edema. 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 . PATIENT EDUCATION WHILE TAKING THIS MEDICATION Temp: Creatinine: 0 (0.8-1). PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. 15 x 16 = 240. had a sudden increase in pain in her abdomen. 1. c) Ask the parent whether the pt is hurting Naltrexone: -opioid receptor antagonist that reduces the. PO (Children 612 yr): 40150 mg in 14 divided doses. Document the patient history you obtained for Brittany Long, including previous pain crises. Hct: 29 (40-45%) Blood pressure:riate. 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. Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). and is Respiration: 25. Company Registration Number: 61965243 I assessed her IV, asked for name and date of birth, and her blood pressure was 101 / 70 and her Which of the following explanations b the nurse is correct? 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 nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. 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 I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: also on 2L nasal cannula. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Promote rest to decrease oxygen consumption. He ordered, normal saline and PRBC infusion to help with the hypovolemia. ECG: normal Sinus rhythm. Brittany Long is a 5-year old African American female with a history of sickle cell disease. Conscious state: Appropriase: Present. Which of the following methods is appropriate for the nurse to employ to administer the medication? 19 terms. Heart rate: 126. From vSim for Nursing | Pediatric. IV fluids with electrolyte replacement (caution with potassium replacement) May cause drowsiness or dizziness. What are you on alert for with this patient? 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? Respiration: 24. The pt is lying quietly in bed watching TV. d)Enuresis and proteinuria. 6a Daily Routine. not meeting the childs fluid requirements, IV fluids are necessary. Hgb 9 (13.5-17) : 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. of hypervolemia and transfusion reaction. 9:03 You took a blood sample. SpO2: 99%. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Class. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 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. Hydration is essential to Conscious state: Appropse: Present. hidy_esther. She rates her pain as a 5/5 on the FACES scale. Pediatric Case : Brittany Long. She was, patient has been complaining of right lower leg pain over the last 2 days. in her right lower legs. Hypovolemia by evidence of pale extremities 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. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. a) I want to listen to you breathe. 4. Severe headache, vomiting, visual changes, A heart rate of 86 bpm and temperature of 37.0C are normal findings. Sickled RBCs, become rigid and cresent shaped. I do about 40 minutes of it five times a week. 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. 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? SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. 1. 37 C c) tachycardia and jaundice Class. Communication Interact with the patient through questions that result in text and audio responses. once at age 4 years for vaso-occlusive crisis The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Brittany Long was diagnosed with sickle cell disease at 6 months old. Hgb is most recently 7 g/dL. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. dizziness The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. There is tenting sign of the skin. Pul97/66 mmHg. and educated the mother about signs of a reaction. 8:10 Child status - ECG: Sinus rhythm. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). a) acute leg pain and dactylitis Long-term therapy may cause 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. 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. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. respiratory depression. 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. I then preformed an assessment on her abdomen. 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. Cheever), Pediatric Case 04 Sabina Vasquez Complex GRQ, Pediatric Case 04 Sabina Vasquez Complex DA, Managing Engaging Learning Environments (D095), Educational Psychology and Development of Children Adolescents (D094), Success Strategies for Online Learning (SNHU107), Medical/Surgical Nursing Concepts (NUR242), Health-Illness Concepts Across the Lifespan I (NUR 1460C), Concepts Of Maternal-Child Nursing And Families (NUR 4130), Legal Issues in Information Security (C 841), Financial Statement Analysis/Business Valuation (ACC345), Maternity and Pediatric Nursing (NUR 204), 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), A&P II Chapter 21 Circulatory System, Blood Vessels, General Chemistry I - Chapter 1 and 2 Notes, Logica proposicional ejercicios resueltos.
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