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. times/day to 3 times/wk. antirheumatics Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. Respiration: 24. 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. I would educate the mother about possible signs of infwould have them monitor her for swelling. emergency Department at 0600. Acute chest b) Tachycardia and jaundice. Pul106/73 mmHg. Hypovolemia by evidence of pale extremities Tolerance is not addiction. anemia or sickle cell trait Look for signs oection such as fever and shortness of breath. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. nonsteroidal anti inflammatory agents pain 02 mg/kg/hr. 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 . not meeting the childs fluid requirements, IV fluids are necessary. avoid a sickle cell crisis in the future. The nurse is performing a physical assessment on a 5 y/o pt. Sets found in the same folder. Electrolytes early recognition are critical in preventing respiratory complications and failure. 2. Making a purchase. IV fluids with electrolyte replacement (caution with potassium replacement) hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). fluids. nonopioid analgesics 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. Vaso-occlusive pain crisis from sickle cell anemia a) Sickle cell anemia is transmitted through he father. 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The faulty received a unity of PRBCS. PATIENT EDUCATION WHILE TAKING THIS MEDICATION She is on D5NS fluids at 52 mL/hr. Normal red blood cells are round. Temp: 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. Making a Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 4. Pediatric Case 7: Brittany Long (Core) 1. has been complaining of right lower leg pain The child looked slightly The patient was admitted due to complaining of right lower leg pain for the 2 . vSim for Nursing Pediatric | Laerdal Medical She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Neutrophils and bans are She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. SpO2: 99%. Heart rate: 125. lymphocytes monocytes increase is CBC w/ dif : SHOULD be ordered to The nurse is teaching Brittany how to use the FACES scale to rate pain. and levels of neutrophils, changes in department during the night by her mother, who stated that the patient has been complaining NS and PRBCs. VSim Brittany Long Pre/Post test Flashcards | Quizlet Pul97/66 mmHg. Maintain adequate fluid intake and monitor urine output. 1. 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. s relative. The parent replied: 'No. c) Enuresis and proteinuria. 15 x 16 = 240. female with a history of sickle cell disease, Monitor O2 saturation levels Britney long is a 5 year old African American Temp: PURPOSE FOR TAKING THIS MEDICATION, Treatment of: determine anemia state & if there is Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent pain crises before, mostly managed at home with acetaminophen and ibuprofen. vSim for Nursing Maternity and Pediatric - Laerdal Medical Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. If oral fluids are then assessed her IV and she seemed nervous, so I offered her a stuff dog who she IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). The. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. It is not necessary to give combining terms for words in parentheses. Heart rate: 125. 4. Patient C/C right lower leg pain over the last 2 days. episode and once at age 3 years for a fever. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. (Clinical slides 02.02) 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. : 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. 34 hr initially. Britney rated her pain as a 5 on the faces 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Brittany Long Complex VSIM.docx - Course Hero Bp is trending low, she has normal saline running at 320 ml/hr and has recently Pediatric Case 07 Brittany Long Core DA rev - StuDocu 1. used to assess Intercranial vascular and pain management. and the abdomen is generally tender. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. a) acute leg pain and dactylitis 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Brittany was given oral pain medication in the emergency department at 6:00 AM. Brittany hepatomegaly Brittany Long Vsim/ Broward College - NUR 250LBrittanyLongVsim - Stuvia 37 C (Clinical slides 02.02.2020), It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS). Normal red blood cells are round. 3. During my initial focused assessment of Brittany Long I found that her vital signs were She has had pain crises before, mostly managed at VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. greenstickynotes. (In pain) She well' replied: 'Not too. intravenous maintenance fluids at 52 milliliters Transcribed image text: Patient Introduction 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. Document your initial focused assessment of Brittany Long. Fluid and Electrolyte levels stabilized and maintained. c) Drinking to much water can trigger another crisis. No known allergies, immunizations are up to date. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . The padon't think so.' rent replied: 'No. o Ther. 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? Verify your answer in a medical dictionary. 2. She has had pain crises before, mostly a) acute leg pain and dactylitis Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia VSim Brittany Long Pre/Post test. prevent further VOC and complications of SCD and to provide relief of pain. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. d) You need to change into hospital gown before I can examine you. Do not stop taking without discussing with health care professional; administer blood products, usually packed RBCS an exchange transfusions per facility protocol. a) immunization hx Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options a) FLACC scale PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Reduction of fever. SpO2: 99%. Temp: Location A is 3.00 m to the right of a point charge q. Children should never be force to change into a gown. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 0:10 Child status - ECG: Sinus rhythm. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Assess dehydration status via CBC, Urinalysis and strict I/O. antipyretics 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. individual for whom it was prescribed. Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION once at age 4 years for vaso-occlusive crisis Continuous infusion, sickle cell or cancer 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. Keep I have given her morphine 2 mg IV Push and have also bolused Her Terms of Use hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. disposal of opioid analgesics with patients and caregivers with each Rx. Recommendation: Educate the patient and family about the importance of hydration I monitored her respiratory rate for any (Signs & Symptoms), 3. Use preservative-free formulation. Heart rate: 126. You should have identified the relative, ng the child's before providing Brittany Long was diagnosed with sickle cell disease at 6 months old. Discuss safe use, risks, and proper storage and She did I assessed her IV, asked for name and date of birth, and given. Company Registration Number: 61965243 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. 37 C The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Pul108/73 mmHg. 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. Student exploration Graphing Skills SE Key Gizmos Explore Learning. I worked my way up to an hour of cardio per workout session. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. Voc Latin page 24. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. tired. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . She now rates her pain as a 3. Obstructive jaundice Pain level controlled and maintained, avoiding. o Therapeutic: opioid analgesics ven over 30 minutes. SpO2: 99%. 1. Document the patient history you obtained for Brittany Long. She is a 5-year-old female with a history of sickle cell anemia. faces scale. Class. CLASSIFICATION: Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Blood pressure:te. are inadequate (extended release). PO (Children 36 yr): 2060 mg in 14 divided doses. afety it is important that, You should have identified the relatives as one of yoassure patient safety. 13:3 9 You phoned the provider in order to discuss the patient. 37 C Instruct patient to take medication as directed. electrolyte imbalance and dependence. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu Her pulse measured 160bpm, her respirations were 34, and her blood Pain management by evidence of pain in right lower leg The nurse is assessing for which of the following complications of vast-occlusive crisis? 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? Pul110/74 mmHg. From vSim for Nursing | Pediatric. 8:13 You provided patient education. 37 C I f dehydration, look at her legs frequently. VSim Sabina Vasquez Pre/Post test. of hypervolemia and transfusion reaction. : 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. encouraging fluids, she kept drinking as I gave her fluids. Hence, his ministry is inclusive and hope-bearing. The parent ; 7:32 You asked the parent: Is there anything else tknow? PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. To maintain patient syou quickly identify the child. flow and detect the risk for cerebral Family history of sickle cell What would be the most appropriate med for the nurse to administer? Timely pain management. NSAIDs. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. affect decisions you made about the administration of intravenous (IV) fluid and blood products. every 34 hr, maximum: 15 mg/dose. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. Ninon_sassy. 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. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 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. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." 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. May cause drowsiness or dizziness. A step-by-step guide to craft a winning sales presentation . Strict I and 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. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Blood pressure:riate. Document the patient teaching that you would provide for Brittany Long and her family black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. priapism I don't think so.' llergies? The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Heart rate: 127. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. When examined this morning, her blood pressure was 101/ Location B lies on the same line and is 4.00 m to the right of the charge. a left (bacterial) or right shift (viral) 8:10 Child status - ECG: Sinus rhythm. (SBAR) format to communicate what further care Brittany Long needs. Her pain was a 3/5 on FACES scale Student exploration Graphing Skills SE Key Gizmos Explore Learning. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. $16.49 Add to cart . normal saline and PRBC infusion to help with the hypovolemia. Temp: PO (Children 612 yr): 40150 mg in 14 divided doses. SpO2: 98%. And Hct. Patient Dose: 2mg IV She didnt have any reaction If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. As blood flow is impaired by sickled cells, vasospasm occurs, further. 37 C 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. precipitating factor in sickle cell crises. vSim - Brittany Long. of right lower leg pain over the last 2 days. PROTOTYPE: Morphine. occlusive crisis. 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. 0 mg/kg every 12 hr. hhulsey6. 1) Have the patient lie down in a supine position. Naltrexone: -opioid receptor antagonist that reduces the. For the latest news, offers and ideas, sign up to our newsletter. I monitored her respiratory rate for any, respiratory depression. kuuleinani1102. takes regular folic acid supplement as prescribed. developmentally appropriate pain scale and assessment of pain behaviors are essential in Brittany Long Core- vSim.docx - Brittany Long Pediatric Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet doses. She brought into the emergency department during the night by her mother, who stated that the In order to maintain trust, it is important to tell children if there is meds mixed into the food. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. care professional if symptoms persist or worsen. Blood pressure:riate. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Sigle prn dose of morphine 2mg was administered. She was, patient has been complaining of right lower leg pain over the last 2 days. 15:1 0 Child status - ECG: Sinus rhythm. o Pharm. Document your initial focused assessment of Brittany Long. reports of pain. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? awakened. Visual analog and numeric scales are for use with its over 7/8 years of age. encouraged PO fluids and she drank some. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Severe headache, vomiting, visual changes, Impaired Gas Exchange 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. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Examined the leg and it was warm. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Acute pain R/T sickle cell disease AEB vaso-occlusive crisis in right leg: The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. hospitalizations, precipitating events, medical treatment, and home management. 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 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. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, brittany vsim | Write my Essay | Assignment Help Transcranial Doppler : Could be I then preformed an assessment on her abdomen. Signs of stroke i. Finish the reading attached below and complete the | Chegg.com Conscious state: Appropse: Present. Jackson Weber VSim Post-Sim Q's. 10 terms. This is correcevery opportunity to provide patient education. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Recent flashcard sets . SAFE DOSE OR DOSE RANGE, SAFE ROUTE Patients who are immobile are at greater Sickle Cell Anemia: is a blood disease that affects red blood cells. She has gained 3 pounds since prenatal visit 1 week ago. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Heart rate: 109. Before discharging Brittany Long and her family, I would educate them on how to breathing, application of heat, and offering a toy are all effective ways of managing pain. Which of the following would be the best response by the nurse? You don't have to be crying to be hurting a lot. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. c) tachycardia and jaundice She was brought into the emergency A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. NURS 3440 (NURS3440) Institution. Pul98/67 mmHg. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood.

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