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. Temp: before discharge. NS and PRBCs. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Sickle Cell Anemia: is a blood disease that affects red blood cells. No known allergies, immunizations are up to date. 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 37 C I would educate the mother about possible signs of infwould have them monitor her for swelling. CLASSIFICATION: respiratory depression. Which of the following explanations b the nurse is correct? VSim Brittany Long Pre/Post test. I f dehydration, look at her legs frequently. 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? Her pain was a 3/5 on FACES scale 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. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Respiration: 25. The pt is lying quietly in bed watching TV. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). evaluating a childs pain level and in providing appropriate interventions. Class. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . : 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. Management of Care: What needs to be done for this Patient Today? Look for signs oection such as fever and shortness of breath. I stayed to watch for a transfusion reaction. Heart rate: 126. Do your children have different fathers? flow and detect the risk for cerebral Document your initial focused assessment of Brittany Long. 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. a) Choose the face that looks like how you feel inside. Terms of Use dizziness Jackson Weber VSim Post-Sim Q's. 10 terms. Brought into the ED by her mother last night. I/O can be calculated by UAP. Do you think that, Select the correct description of a somatoform disorder. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Pediatric Case 7: Brittany Long (Core) Documentation Assignments. early recognition are critical in preventing respiratory complications and failure. SpO2: 98%. 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 . To maintain patient syou quickly identify the child. Monitor her 02 sat and keep above 94%. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). New orders have been. care professional if symptoms persist or worsen. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE He ordered The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Neutrophils and bans are bacterial. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Which of the following would be the best response by the nurse? poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids SpO2: 99%. Patients who are immobile are at greater b) Tachycardia and jaundice. She is a 5-year-old female with a history of sickle cell anemia. 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. hands and feet cool to touch. Many OTC products contain ibuprofen; avoid duplication. Reduction of fever. Vaso-occlusive pain crisis from sickle cell anemia c) Past hospitalizations and Tx Maintain adequate fluid intake and monitor urine output. Morphine 2mg IV given as (In pain) She well' replied: 'Not too. 18 terms. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Britney long is a 5 year old African American Documentation Assignments. occlusive crisis. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Pain level controlled and maintained, avoiding. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Instruct patient how and when to ask for pain medication. 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. Promote rest and provide adequate fluids and nutrition. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE 1. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Family history of sickle cell Heart rate: 126. Instruct patient to take medication as directed. blood and then administered it. I prevent further VOC and complications of SCD and to provide relief of pain. 9:31 You gave the child a sip of juice. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Recommendation: Educate the patient and family about the importance of hydration PO (Children 612 yr): 40150 mg in 14 divided doses. normal saline and PRBC infusion to help with the hypovolemia. and educated the mother about signs of a reaction. Examined the leg and it was warm. c) tachycardia and jaundice Normal red blood cells are round. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Blood pressure:te. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. and her temperature was 37C (99F). Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). antirheumatics Hence, his ministry is inclusive and hope-bearing. ECG: normal Sinus rhythm. CLASSIFICATION: Hypovolemia by evidence of pale extremities hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Conscious state: Appropse: Present. prescribed was given for her pain. 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 Pain reported at 3, assessed on the FACES scale. provided education to 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. Document your initial focused assessment of Brittany Long. 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: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. brittany long complex vsim documentation. Take note of c) FACES scale New orders have been Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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! I maintenance fluids at 52 mL/hr. We have noticed you are logged in to ${country}. The patient was diagnosed with sickle cell anemia and was in a VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Heart rate: 109. slurred speech, What Assessments will focus on for this patient? every 34 hr, maximum: 15 mg/dose. Sickled RBCs, become rigid and cresent shaped. 37 C Severe pain, usually in bones For the latest news, offers and ideas, sign up to our newsletter. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. What are you on alert for with this patient? 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. . Respiration: 24. are inadequate (extended release). Jackson Weber VSim Post-Sim Q's. 10 terms. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy SpO2: 97%. 4. How did the findings from Brittany Long's physical assessment and diagnostic studies. 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. 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 of hypervolemia and transfusion reaction. Temp: 1. Neutrophils and bans are She was 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! Normal bowel habits are variable and may vary from 3 She looked visually uncomfortable and reported feeling pain, a 6/10 on the hospitalizations, precipitating events, medical treatment, and home management. Pediatric Case 7: Brittany Long (Core) 1. of hydration with patients who have sickle cell anemia. 0:10 Child status - ECG: Sinus rhythm. Dehydration is often a Heart rate: 127. vSim for Nursing allows each student to have a different experience with the patient. a) I want to listen to you breathe. o Ther. She rates her pain as a 5/5 on the FACES scale. And Hct. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 19 terms. dispensed with the medication. 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 given. c) Past hospitalizations and Tx PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. 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? The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Reticulocytes 5 (0.5-1%) Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Recommended dosage is PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 h Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. d) Anemia and hypotension. You don't have to be crying to be hurting a lot. Skip to document. 37 C bacterial. 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. Conscious state: Appropse: Present. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. 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. and basic metabolic panel, Blood analysis (notable): not meeting the childs fluid requirements, IV fluids are necessary. Disulfiram: NMDA receptor antagonist & GABAA agonist B . 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. Background: Brittany Long has a history of sickle cell anemia being treated with a folic You should have identified the relative, ng the child's before providing Signs of stroke i. SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. for a fever. red blood cells become rigid and shaped like crescent moons or sickles. May cause drowsiness or dizziness. a) immunization hx Blood pressure:riate. syndrome can develop in children with sickle cell crisis. I assessed her IV, asked for name and date of birth, and Her skin is quite cold. Conscious state: Appropse: Present. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Blood pressure:riate. In a vaso-occlusive crisis / painful Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 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. Sets found in the same folder. 2. Identify and document key nursing diagnoses for Brittany Long. Course Hero is not sponsored or endorsed by any college or university. She has been taking small amounts I She is asleep but is responsive when Respiration: 24. 6:22 You asked the child how long she had pain for. She was brought into the emergency Hgb 9 (13.5-17) Child Life can assist in making the child comfortable and regulating anxiety levels. Place the steps of an abdominal assessment in order. a) Sickle cell anemia is transmitted through he father. 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 During my initial focused assessment of Brittany Long I found that her vital signs were 0:25 You washed your hands. I have a weekly show-- Ease Into . What would be the most appropriate med for the nurse to administer? Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. S: This is Brittany Long. played with and became more comfortable with. closely monitor laboratory results reporting any notable , out of range levels , NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE, MEDICATION: Morphine sulfate 2 mg IV (o mg/kg/dose) X 1 on the FACES Scale. 18 terms. faces scale. temperature was 37 Celsius she now rates X SAFE DOSAGE Pul108/73 mmHg. Visual disturbances. I do about 40 minutes of it five times a week. Patient C/C right lower leg pain over the last 2 days. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: 3. Conscious state: Appropse: Present. Conscious state: Appropriase: Present. CLASSIFICATION: Pul97/66 mmHg. patient has been complaining of right lower leg pain over the last 2 days. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Location B lies on the same line and is 4.00 m to the right of the charge. The nurse is teaching Brittany how to use the FACES scale to rate pain. Educate patient and family on nutritional and fluid needs. This is correcevery opportunity to provide patient education. nonopioid analgesics 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? If that is not sufficient to manage their pain, they may require morphine for episode Pul98/67 mmHg. priapism encouraged PO fluids and she drank some. Normal red blood cells are round. a) acute leg pain and dactylitis A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. 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. 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 . PO (Children 23 yr/2435 lb): 100 mg every 68 hr. She was admitted to the Pediatric unit this morning . c) I am going to take your temp. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. 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Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Pul110/74 mmHg. 13:3 9 You phoned the provider in order to discuss the patient. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ The parent ; 7:32 You asked the parent: Is there anything else tknow? c) Use a dropper to place med in back of the pt's throat brought into the emergency department during the night by her mother, who stated that the Pediatric Case : Brittany Long. 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. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. and levels of neutrophils, changes in of infection and dehydration, and pain management. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Blood pressure:riate. Verify your answer in a medical dictionary. PO (Children 36 yr): 2060 mg in 14 divided doses. SAFE DOSE OR DOSE RANGE, SAFE ROUTE