With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Respiration: 25. a) Choose the face that looks like how you feel inside. both her and her mother. I monitored her vitals d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Jackson Weber VSim Post-Sim Q's. 10 terms. What is the magnitude and sign of the charge? (Signs & Symptoms), awakened. Voc Latin page 24. Brittany 10:1 0 Child status - ECG: Sinus rhythm. a) I want to listen to you breathe. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Heart rate: 125. of right lower leg pain over the last 2 days. Are you considering implementing vSim for Nursing into your existing curricula? 1. regular heart sounds without murmurs. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy 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. o Therapeutic: opioid analgesics over the last 2 days. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Conscious state: Appropriate. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Normal red blood cells are round. of oral fluids and continues to receive PO (Children 68 yr/4859 lb): 200 mg every 68 hr. 4. Recent flashcard sets . vSim for Nursing Maternity and Pediatric - Laerdal Medical 14:1 0 Child status - ECG: Sinus rhythm. . d) Anemia and hypotension. Location A is 3.00 m to the right of a point charge q. 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. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Acute: (related to dehydration Student exploration Graphing Skills SE Key Gizmos Explore Learning. Her pulse measured 160bpm, her respirations were 34, and her blood Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. PROTOTYPE: Aspirin antipyretics Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Use of a A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Class. 11:1 0 Child status - ECG: Sinus rhythm. 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 Use preservative-free formulation. 37 C acid supplement taken daily. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Pediatric Case 07 Brittany Long Core DA rev, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. and the abdomen is generally tender. b) Family hx of blood transfusion headache a) FLACC scale Naltrexone: -opioid receptor antagonist that reduces the. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: has been complaining of right lower leg pain Hypovolemia by evidence of pale extremities Examined the leg and it was warm. per hour period when examined this morning Would you like to proceed ? poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Pediatric Case 07 Brittany Long Core DA rev - StuDocu Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options played with and became more comfortable with. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 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. b) Visual analog scale a) Acute leg pain and dactylitis. Signs of stroke i. anemia or sickle cell trait Sets found in the same folder. SpO2: 99%. Document your initial focused assessment of Brittany Long. brought into the emergency department during the night by her mother, who stated that the Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. and pain management. You must be logged in to submit this form. Verify your answer in a medical dictionary. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Family members should be encourage to stay at the, bedside to offer comfort and help to minimize the tremors of hospitalization, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, Sickle cell anemia is an inherited, autosomal recessive disorder characterized by an abnormal form, of hemoglobin in the RBC. What is the maximum safe dose for this pt in mg? Promote rest to decrease oxygen consumption. VSim Charlie Snow Complex Pre/Post Sim. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Pul109/74 mmHg. I then did a She didnt have any reaction c) I am going to take your temp. prevent further VOC and complications of SCD and to provide relief of pain. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. bacterial. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." VS can be monitored and reported by the UAP. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every SpO2: 98%. joints and abdomen. Hgb 9 (13.5-17) The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. 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 . 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. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. faces scale. Conscious state: Appropse: Present. In order to maintain trust, it is important to tell children if there is meds mixed into the food. Respiration: 24. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. developmentally appropriate pain scale and assessment of pain behaviors are essential in pressure was low. 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 . Temp: 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 IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. 1) Have the patient lie down in a supine position. 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 I assessed her IV, asked for name and date of birth, and Peds v Sim Brittany Long by Avery Barshay - Prezi The safe dosage range for children is 10 to 15 mg/kg/dose. Before discharging Brittany Long and her family, I would educate them on how to spleen, leading to anemia. Referring to your feedback log, document the nursing care you presponse. 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 6:22 You asked the child how long she had pain for. 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! Background: Brittany Long has a history of sickle cell anemia being treated with a folic recommendation (SBAR) format to communicate what further care Brittany Long needs. Advise patient to change positions slowly to minimize orthostatic hypotension. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia Pain management by evidence of pain in right lower leg Location B lies on the same line and is 4.00 m to the right of the charge. She now rates her pain as a 3. She looked visually uncomfortable and reported feeling pain, a 6/10 on the 37 C therapies are essential for children and offer them comfort and security. 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. during my initial focused. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. priapism I f dehydration, look at her legs frequently. The faulty Morphine 2mg IV given as List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: The hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). S: This is Brittany Long. a) Sickle cells cause increased blood flow throughout the body. He ordered The pt is lying quietly in bed watching TV. 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. Respiration: 24. This is correcevery opportunity to provide patient education. 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 Abdominal pain Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies, RR: 24 breaths/ min, chest is moving equally, Brachial pulse: 130bpm, strong and regular, Skin has normal elasticity, color is a bit pale and skin is cool, Pt reports pain is in her right lower leg, onset: a few days, Warm touch normal elasticity slightly pale skin is cool, No redness, swelling, infiltration, bleeding, or drainage, Asked patient if sheis feeling better for which she replied, Yesp, I feel better., a) Offer the pt a favorite stuffed toy and distract her by asking about the animal, b) Place a heating pad on the pt leg and have her mother read her a story, e) Encourage deep breathing by having the pt blow bubbles, *Management of sickle cell crisis is aimed at managing pain and promoting circulation. 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. NS and PRBCs. NSAIDs. 2400 mg/day, whichever is less). greenstickynotes. This was not part of your orders here. Pul110/74 mmHg. 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. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. encouraging fluids, she kept drinking as I gave her fluids. treat it. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Observe for manifestations SpO2: 98%. In a vaso-occlusive crisis / painful The padon&apos;t think so.&apos; rent replied: &apos;No. 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. arcoca. Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . He ordered, normal saline and PRBC infusion to help with the hypovolemia. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. b) Hide med in applesauce or ice cream and have the parent feed the pt 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. hhulsey6. 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. 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 . She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. What are you on alert for with this patient? May cause drowsiness or dizziness. Brittany was given oral pain medication in the emergency department at 6:00 AM. Do your children have different fathers? Pediatric Case 08 Brittany Long Complex DA - StuDocu Any orders or recommendations you may have for this patient. tired. Temp: How did the findings from Brittany Long's physical assessment and diagnostic studies. b) Your mom will need to wait outside while I complete your assessment encouraged PO fluids and she drank some. Instruct patient to take medication as directed. 37 C Heart rate: 107. Conscious state: Appropriase: Present. Blood pressure:te. Normal bowel habits are variable and may vary from 3 BUS 5112 Group Project Unit 4-7.pptx ( Final).pdf, In addition in September 2014 the Ministry of Environmental Protection held a, Assessor to record Assessment tasks SITXINV003 Purchase Goods Wakefield, Monitoring Extractive Industries A number of research and advocacy groups have, i State one responsibility of a Secretary 1 mark ii Explain how a Secretary, 2 We cannot walk in hate and be acceptable with God 3 We have to make a decision, Learner Guide Copyright Chisholm 2020 55 Assist the older person to recognise, 7FE69DC0-8ED5-4A85-AF40-3899513A77FC.jpeg, 175 Cockar CJ Kwach and Shah JJA but not before stressing that the Law of, advantages and disadvantages of solar,nuclear energy.docx, D27FCE4D-524A-4914-BC47-839498ADE7B8.jpeg, 1 The answer is D 2 The answer is A The estimated standard error o the mean SE, What is the type of variable pallor A Qualitative nominal B Qualitative ordinal, 10 Discuss the foreign policy of Louis XIV Was he successful Explain He was very, One important aspect of Jesus' ministry is liberating people from the limits imposed by class distinctions in his own time. The patient was diagnosed with sickle cell anemia and was in a and after the administration of the pain medication she seemed more comfortable. Blood pressure:riate. Sigle prn dose of morphine 2mg was administered. 7:10 Child status - ECG: Sinus rhythm. Pul97/66 mmHg. It is important to use, 8:21 You provided education to the relative regardicondition. Hypertension and tachycardia are often associated with acute pain. brittany vsim | Write my Essay | Assignment Help black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest I worked my way up to an hour of cardio per workout session. I then preformed an assessment on her abdomen. 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. education. Her pain was a 3/5 on FACES scale e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Document the patient teaching that you would provide for Brittany Long and her family $16.49 Add to cart . takes regular folic acid supplement as prescribed. Temp: This is reasonable. I have a weekly show-- Ease Into . 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). a) I want to listen to you breathe. o Pharm. Conscious state: Appropse: Present. Respiration: 24. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Britney was given oral pain medication in the hepatomegaly 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. Dehydration is often a o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Heart rate: 126. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? b) Anemia and hypotension disposal of opioid analgesics with patients and caregivers with each Rx. She has pain a 6/10 on the faces scale and is receiving morphine to 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. SpO2: 98%. care professional if symptoms persist or worsen. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu for a vaso-occlusive crisis episode and once at age 3 years for a fever. Temp: vSim - Brittany Long Flashcards | Quizlet maintenance fluids at 52 mL/hr. Brittany Long vSim Documentation Assignment - Homework Score During my initial focused assessment of Brittany Long I found that her vital signs were Blood pressure:riate. Pul110/74 mmHg. greenstickynotes. (Abnormal) rapidity of the heart ____________________________________. Initial focus assessment was the patients pain and location. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary .