Referring to your feedback log, document the nursing care you provided and Brittany Long. syndrome can develop in children with sickle cell crisis. There is tenting sign of the skin. Examined the leg and it was warm. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Brittany rated her pain Conscious state: Appropse: Present. brittany vsim | Write my Essay | Assignment Help Respiration: 25. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. It is not necessary to give combining terms for words in parentheses. Monitor and note changes in level of consciousness, reports of headache, dizziness, NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Hematuria The. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. 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. of hydration with patients who have sickle cell anemia. o Pharm. Describe the actions you felt went well in this scenario. Swollen joints, hands and feet by her mother, who stated that the patient What is the magnitude and sign of the charge? Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. What action should the nurse take? Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." and her mother about why those were being given. signs Q2 hours. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. She has had pain crises before, mostly abdomen is generally tender. She was brought into the emergency PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. The nurse is assessing for which of the following complications of vast-occlusive crisis? of infection and dehydration, and pain management. Voc Latin page 24. Hgb 9 (13.5-17) Labs; daily complete blood count may cause withdrawal symptoms if discontinued abruptly after prolonged use. episode 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 . Heart rate: 127. 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. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. VSim Sabina Vasquez Pre/Post test. IV Neonates: Continuous infusion 00 mg/kg/hr. Location A is 3.00 m to the right of a point charge q. (In pain) She well' replied: 'Not too. Documentation Assignments. 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. 13 terms. bacterial. a) Acute leg pain and dactylitis. The parent replied: 'No. 9:03 You took a blood sample. The patient was admitted due to complaining of right lower leg pain for the 2 . Heart rate: 107. Document your initial focused assessment of Brittany Long. determine anemia state & if there is Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Conscious state: Appropse: Present. Brought into the ED by her mother last night. 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. Normal bowel habits are variable and may vary from 3 I don't think so.' llergies? 15 x 16 = 240. 1. X SAFE DOSAGE 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 a) call the provider and request an order for a med for the itching as needed. given. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. She has had The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). NS and PRBCs. Pul110/74 mmHg. kuuleinani1102. splenomegaly Vital 1. Document the patient history you obtained for Brittany Long. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. The spleen is enlarged, Take missed doses as soon as remembered but not if almost time for next dose. Diagnosed with sickle cell disease at age 6 months. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu 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. SpO2: 98%. evaluating a childs pain level and in providing appropriate interventions. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. a) FLACC scale Blood pressure:riate. Respiration: 24. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . takes regular folic acid supplement as prescribed. Identify and document key nursing diagnoses for Brittany Long. On inspection, the pt's skin is flat & w/o erythema. Sickled RBCs, become rigid and cresent shaped. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Patient C/C right lower leg pain over the last 2 days. SpO2: 98%. Britney was given oral pain medication in the He ordered What are you on alert for with this patient? Making a purchase. : 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. dispensed with the medication. of hypervolemia and transfusion reaction. She was admitted to the Pediatric unit this morning . PRBCS. She has gained 3 pounds since prenatal visit 1 week ago. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Care of the childrearing family (nurs420). Respiration: 25. Pain level controlled and maintained, avoiding. Family history of sickle cell Conscious state: Appropse: Present. b) Anemia and hypotension Terms of Use She now rates her pain as a 3. I do about 40 minutes of it five times a week. antirheumatics both her and her mother. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 15:4 1 A patient handoff was performed. Respiration: 15. 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. 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. 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. 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. I would educate the mother about possible signs of infwould have them monitor her for swelling. managed at home with acetaminophen and PO Infants: 5 mg/kg/day in 14 divided doses. Her skin is quite cold. 37 C Which of the following explanations by the nurse correctly describes how to use the scale? The right lowertouch. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. d) Frequency of vaso-occlusive crises If you change the Country/Language, you will be logged out. 1. 19 terms. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid education. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Document your initial focused assessment of Brittany Long. She has been hospitalized twice, Continuous infusion, sickle cell or cancer Initial focus assessment was the patients pain and location. VSim Brittany Long Pre/Post test Flashcards | Quizlet I verified with two nurses in regard to the Britney long is a 5 year old African American I need you to help me hold my stethoscope in place. sickle cell crisis. jaundice NSAIDs. Promote rest and provide adequate fluids and nutrition. Sets found in the same folder. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Monitoring oxygenation, use of incentive spirometry, hydration, and Decreased pain and inflammation. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. When examined this morning, her blood pressure was 101/ breathing, application of heat, and offering a toy are all effective ways of managing pain. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth What would be the most appropriate med for the nurse to administer? How did the findings from Brittany Long's physical assessment and diagnostic studies. played with and became more comfortable with. 2. 0 mg/kg every 12 hr. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Your other child definitely carries the trait 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. She is on D5NS fluids at 52 mL/hr. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. 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. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. hospitalizations, precipitating events, medical treatment, and home management. Which of the following would be the best scale to use w/ this pt? 37 C I b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness has been taking small amounts of oral fluids and continues to receive intravenous Hydration is essential to 13 terms. 18 terms. b) Visual analog scale Pul108/73 mmHg. nonopioid analgesics 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! During my initial focused assessment of Brittany Long I found that her vital signs were 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. 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Conscious state: Appropse: Present. 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. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg e) Precipitating events In order to maintain trust, it is important to tell children if there is meds mixed into the food. individual for whom it was prescribed. (Signs & Symptoms), 3. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. pain 02 mg/kg/hr. Tolerance is not addiction. and is c) FACES scale Conscious state: Appropriase: Present. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. Patients who are immobile are at greater Heart rate: 128. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? developmentally appropriate pain scale and assessment of pain behaviors are essential in d) You need to change into hospital gown before I can examine you. her blood pressure was 101 / 70 and her Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. 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. Blood pressure:riate. 1. Heart rate: 127. (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). b) Tachycardia and jaundice. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. risk for this complication. PATIENT EDUCATION WHILE TAKING THIS MEDICATION c) Drinking to much water can trigger another crisis. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . North Carolina State University. Her pain was a 3/5 on FACES scale There is tenting sign of the skin. 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). Company Registration Number: 61965243 Temp: d) decreased hgb, increased platelet, greatly elevated reticulocyte. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Acute Pain slurred speech, What Assessments will focus on for this patient? Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Hgb is most recently 7 g/dL. scale and did not want anyone to touch her TCD is performed annually on 8:10 Child status - ECG: Sinus rhythm. Initial focus assessment was the patients pain and location. Assess dehydration status via CBC, Urinalysis and strict I/O. 37 C I don't thhat you think we should ink so.' 7:47 You offered the child a toy. b) Reassess the pt in 15mins to see whether the pain rating has changed Pennsylvania College of Technology. are inadequate (extended release). (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? Patient Dose: 2mg IV normal saline and PRBC infusion to help with the hypovolemia. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. d) Frequency of vaso-occlusive crises To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Discuss safe use, risks, and proper storage and referral to the pain team may also be helpful in SCD crises management. Brittany was given oral pain medication in the emergency department at 6:00 AM. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Her Pediatric Case 08 Brittany Long Complex DA - StuDocu Brittany Long is a 5-year old African American female with a history of sickle cell disease. SpO2: 99%. Educate patient and family on nutritional and fluid needs. PO (Children <3 yr): 1040 mg in 14 divided doses. and levels of neutrophils, changes in This is correcevery opportunity to provide patient education. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. B: She came in with right lower leg pain, and that has since been stabilized, but she has Reduction of fever. provided education to CLASSIFICATION: The potential difference between the two locations is. Reticulocytes 5 (0.5-1%) c) Ask the parent whether the pt is hurting Identify and document key nursing diagnoses for Brittany Long. Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Infant, Child And Adolescent Nursing (NSG 441). Document your initial focused assessment of Brittany Long. 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. Obstructive jaundice Pul110/74 mmHg. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. Brittany VSIM. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 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. c) Morphine bc the pt reports severe pain. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Continuous Pulse Oximetry: Creatinine: 0 (0.8-1). department during the night by her mother, who stated that the patient has been complaining The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health Temp: 5 touch. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Temp: VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia intake (68 full glasses/day), and increasing mobility. Visual disturbances. IV fluids with electrolyte replacement (caution with potassium replacement) I administered more fluids and It is important to use, 8:21 You provided education to the relative regardicondition. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. on the FACES Scale. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. in her right lower legs. She now rates her pain as a 3. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. (Signs & Symptoms), awakened. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! Document your initial focused assessment of Brittany Long. CLASSIFICATION: (SBAR) format to communicate what further care Brittany Long needs. 10:1 0 Child status - ECG: Sinus rhythm. She has been her pain as a three. and BP now and educated the mother about signs of a reaction. 8:13 You provided patient education. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. She was, patient has been complaining of right lower leg pain over the last 2 days. 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