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13:2 3 You examined the child's legs. b) Visual analog scale 19 terms. She has been taking small amounts normal saline and PRBC infusion to help with the hypovolemia. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and She is a 5-year-old female with a history of sickle cell anemia. Respiration: 24. This is correcevery opportunity to provide patient education. Reticulocytes 5 (0.5-1%) PO (Children <3 yr): 1040 mg in 14 divided doses. SpO2: 99%. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? lymphocytes monocytes increase is 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 called her provider to see what else I should do. per hour period when examined this morning When examined this morning, her blood pressure was 101/ Fluid and Electrolyte levels stabilized and maintained. treat it. 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 . o Therapeutic: opioid analgesics Blood pressure:riate. and educated the mother about signs of a reaction. The nurse is performing a physical assessment on a 5 y/o pt. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation For the latest news, offers and ideas, sign up to our newsletter. SpO2: 99%. 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 The nurse is assessing for which of the following complications of vast-occlusive crisis? 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. Pain reported at 3, assessed on the FACES scale. 37 C Document your initial focused assessment of Brittany Long. She is asleep but is responsive when sickle cell disease. c) Morphine bc the pt reports severe pain. 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. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? She looked visually uncomfortable and reported feeling pain, a 6/10 on the Heart rate: 127. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. 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. Jackson Weber VSim Post-Sim Q's. 10 terms. Class. 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 . The potential difference between the two locations is. Making a purchase. Labs; daily complete blood count precipitating factor in sickle cell crises. SpO2: 98%. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Pul109/74 mmHg. nonopioid analgesics every 34 hr, maximum: 15 mg/dose. breakthrough pain. This is reasonable. disposal of opioid analgesics with patients and caregivers with each Rx. Educate patient and family on nutritional and fluid needs. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . PDA Closure The patient was diagnosed with sickle cell anemia and was in a diagnosed at six months old and has been Recommendation: Educate the patient and family about the importance of hydration ven over 30 minutes. Antipyretic 5 mg/kg for vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Britney long is a 5 year old African American Neutrophils and bans are You should have asked the relative about any known health problems. maintenance fluids at 52 mL/hr. Verify your answer in a medical dictionary. Respiration: 24. e) Precipitating events. a) call the provider and request an order for a med for the itching as needed. What is the maximum safe dose for this pt in mg? Document your initial focused assessment of Brittany Long. vascular accident (CVA). 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The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. S: This is Brittany Long. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: Manage her pain at home with acetaminophen and drink plenty of fluids. management so it does not turn into a crisis. 3. Pediatric OTC Dosing Her pulse measured 160bpm, her respirations were 34, and her blood Her pain was a 3/5 on FACES scale If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. I The Class: macrolide b) Anemia and hypotension 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! a) acute leg pain and dactylitis I have a weekly show-- Ease Into . line infusion rate to 52. New orders have been a) I want to listen to you breathe. education. Blood pressure:riate. d) decreased hgb, increased platelet, greatly elevated reticulocyte. Identify and document key nursing diagnoses for Brittany Long. Sickled RBCs, become rigid and cresent shaped. Documentation Assignments. Naltrexone: -opioid receptor antagonist that reduces the. b) Family hx of blood transfusion and BP now a) Place med in an oral syringe and allow the pt to squirt into his or her mouth and basic metabolic panel, Blood analysis (notable): Respiration: 15. 37 C Assessment for signs and symptoms of dehydration is She was Strict I and 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! hhulsey6. 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. 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? intake (68 full glasses/day), and increasing mobility. 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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PATIENT EDUCATION WHILE TAKING THIS MEDICATION The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 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. leg during assessment. Blood pressure:riate. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: c) FACES scale Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Jackson Weber Complex Pre/Post Quiz. 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 brittany long complex vsim documentation. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Morphine 2mg IV. CBC due Q 4 hours. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. She also didn't have any energy to eat anything by mouth. A step-by-step guide to craft a winning sales presentation . used to assess Intercranial vascular referral to the pain team may also be helpful in SCD crises management. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Patient C/C right lower leg pain over the last 2 days. To maintain patient syou quickly identify the child. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. 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 R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. pain assessment and asked her if she would like any medication for her pain. Swollen joints, hands and feet Continuous infusion, sickle cell or cancer Monitoring oxygenation, use of incentive spirometry, hydration, and shortness of breath, fatigue MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) $16.49 Add to cart . She did VSim Brittany Long Pre/Post test. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Sets found in the same folder. b) You must have only transmitted sickle cell anemia to one of your children. Voc Latin page 24. 34 hr initially. Which of the following would be the best scale to use w/ this pt? of hydration with patients who have sickle cell anemia. and her mother about why those were being given. Vaso-occlusive pain crisis from sickle cell anemia 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. CLASSIFICATION: 37 C Long-term therapy may cause d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. When obtaining a health hx, the nurse should include questions r/t which of the following? 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. Pul98/67 mmHg. : 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. Initial focus assessment was the patients pain and location. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. hands and feet cool to touch. Blood pressure:riate. Background: Brittany Long has a history of sickle cell anemia being treated with a folic I stayed to watch for a transfusion reaction. 11:1 0 Child status - ECG: Sinus rhythm. NSAIDs. 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? Course Hero is not sponsored or endorsed by any college or university. Document your initial focused assessment of Brittany Long. SpO2: 99%. a) Acute leg pain and dactylitis. Temp: not meeting the childs fluid requirements, IV fluids are necessary. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. pallor, pale mucous membranes joints and abdomen. slurred speech, What Assessments will focus on for this patient? c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy 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. pressure was low. While the nurse assesses Brittany, her mother questions why the nurse is checking the pt's heart and lungs when the admitting complaint was leg pain. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Longs response. a) Sickle cell anemia is transmitted through he father. Respiration: 24. Heart rate: 109. Are you considering implementing vSim for Nursing into your existing curricula? PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). 20 terms. risk for this complication. care professional if symptoms persist or worsen. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I d) You need to change into hospital gown before I can examine you. Stabilizing fluid levels to assist in relieving pain. You should have identified the relative, ng the child's before providing hospitalizations, precipitating events, medical treatment, and home management. Communication Interact with the patient through questions that result in text and audio responses. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Respiration: 24. Do your children have different fathers? 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. blood and then administered it. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest