Pain reported at 3, assessed on the FACES scale. b) Hide med in applesauce or ice cream and have the parent feed the pt 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. maintenance fluids at 52 mL/hr. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Respiration: 24. There is tenting sign of the skin. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. acid supplement taken daily. 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. signs Q2 hours. If that is not sufficient to manage their pain, they may require morphine for 13 terms. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. 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A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. . 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 Continuous infusion, sickle cell or cancer scale and did not want anyone to touch her used to assess Intercranial vascular Temp: I/O can be calculated by UAP. Temp: Impaired Gas Exchange The parent replied: &apos;No - not that I canhat you think we should think of.&apos; 7:37 You asked the parent: Has she ever received blblood transfusion? She now rates her pain as a 3. 14:1 0 Child status - ECG: Sinus rhythm. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, o Recommended dosage is 2060 mg in 14 divided doses Instruct patient how and when to ask for pain medication. c) FACES scale viral. referral to the pain team may also be helpful in SCD crises management. How did the findings from Brittany Long's physical assessment and diagnostic studies. Blood pressure:riate. episode and once at age 3 years for a fever. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. VSim Charlie Snow Complex Pre/Post Sim. Brittany Long - YouTube Recent flashcard sets. The parent replied: &apos;No. played with and became more comfortable with. headache 8:13 You provided patient education. Identify and document key nursing diagnoses for Brittany Long. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. Many OTC products contain ibuprofen; avoid duplication. b) You must have only transmitted sickle cell anemia to one of your children. I Brought into the ED by her mother last night. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. brittany vsim | Write my Essay | Assignment Help 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? The potential difference between the two locations is. We're available through e-mail, live chat and Facebook. 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. Observe for manifestations In people with sickle cell She was brought into the emergency a) Acute leg pain and dactylitis. 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SpO2: 98%. Document your initial focused assessment of Brittany Long. Jackson Weber VSim Post-Sim Q's. 10 terms. Blood pressure:riate. Severe pain, usually in bones 9:03 You took a blood sample. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids a. Xist The nurse is assessing for which of the following complications of vast-occlusive crisis? Respiration: 24. Recommendation: Educate the patient and family about the importance of hydration encouraging fluids, she kept drinking as I gave her fluids. Note that the wording of the dictionary definition may vary from the wording below. 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! 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. e) Precipitating events She did o Ther. on the FACES Scale. o Pharm. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Pul110/74 mmHg. The spleen is enlarged, She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Pul108/73 mmHg. shortness of breath, fatigue b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness treat it. Heart rate: 107. intravenous maintenance fluids at 52 milliliters d) Frequency of vaso-occlusive crises Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. There is tenting sign of the skin. The parent, 3:10 Child status - ECG: Sinus rhythm. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, during my initial focused. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Conscious state: Appropse: Present. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. The nurse is teaching Brittany how to use the FACES scale to rate pain. in her right lower legs. Which of the following should be included in the plan of care for this patient? Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. a) FLACC scale She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. I then did a 37 C 37 C PROTOTYPE: Morphine. 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). In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? IV PCA may also become necessary if pain cannot be controlled. Morphine 2mg IV given as has been taking small amounts of oral fluids and continues to receive intravenous PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Brittany Long was diagnosed with sickle cell disease at 6 months old. ven over 30 minutes. Which of the following should the nurse do? vSim - Brittany Long. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Blood pressure:riate. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. care professional if symptoms persist or worsen. Visual disturbances. She was 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. normal saline and PRBC infusion to help with the hypovolemia. Documentation Assignments. Course Hero is not sponsored or endorsed by any college or university. 0:10 Child status - ECG: Sinus rhythm. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. PRBCS. I educated the patient. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. 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. North Carolina State University. Heart rate: 109. rovided and Brittany Longs, 0:00 You introduced yourself. Making a and educated the mother about signs of a reaction. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Heart rate: 126. has been complaining of right lower leg pain A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Skip to document. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Heart rate: 127. Reduction of fever. (In pain) She. Patient C/C right lower leg pain over the last 2 days. New orders have been VS can be monitored and reported by the UAP. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. VBVA=45.0V. Disulfiram: NMDA receptor antagonist & GABAA agonist B . blood and then administered it. PROTOTYPE: Aspirin Examined the leg and it was warm. Severe headache, vomiting, visual changes, 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. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. arcoca. IV fluids with electrolyte replacement (caution with potassium replacement) Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. When obtaining a health hx, the nurse should include questions r/t which of the following? She has R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. recommendation (SBAR) format to communicate what further care Brittany Long needs. c) Morphine bc the pt reports severe pain. diagnosed at six months old and has been flow and detect the risk for cerebral b) Tachycardia and jaundice. 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. ood or had a reaction to a. Use of a a) acute leg pain and dactylitis Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Vital signs q4h Continuous Pulse Oximetry: Monitor O2 saturation levels Labs; daily complete blood count and basic metabolic panel, Blood analysis (notable): Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5 (0.5-1.5%) Electrolytes Creatinine: 0.4 (0.8-1.4). Naltrexone: -opioid receptor antagonist that reduces the. a) I want to listen to you breathe. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 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. She has gained 3 pounds since prenatal visit 1 week ago. 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. The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. management so it does not turn into a crisis. 15 x 16 = 240. Fluid and Electrolyte levels stabilized and maintained. Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . Tolerance is not addiction. She is asleep but is responsive when Blood pressure:riate. awakened. Over time, the In the ED Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Brittany was given oral pain medication in the emergency department at 6:00 AM. 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. b) Visual analog scale Examined the leg and it was warm. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE of infection and dehydration, and pain management. The right lowertouch. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid From vSim for Nursing | Pediatric. Heart rate: 126. 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. I would also educate on the importance diagnosed at 6 months old, and has been prescribed regular folic acid supplement. vascular accident (CVA). b) Family hx of blood transfusion CBC due Q 4 hours. Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. Initial focus assessment was the patients pain and location. Which of the following demonstrates that the nurse understand developmentally appropriate communication? hidy_esther. kuuleinani1102. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every NS and PRBCs. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Situation: Brittany long is a 5-year-old African American female who has a history of Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION 15:4 1 A patient handoff was performed. SpO2: 97%. and basic metabolic panel, Blood analysis (notable): Pre/Post Simulation for Brittany Long Flashcards | Quizlet 37 C Circulating sickle cells are hemolysized by the. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options I worked my way up to an hour of cardio per workout session. syndrome can develop in children with sickle cell crisis. S: This is Brittany Long. Temp: 37.3. May cause drowsiness or dizziness. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? PO (Children <3 yr): 1040 mg in 14 divided doses. b) Your mom will need to wait outside while I complete your assessment Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. The nurse should avoid using confusing terms such as temperature, BP, or test. 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. 2. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 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. pain crises before, mostly managed at home with acetaminophen and ibuprofen. over the last 2 days. Her skin is quite cold. early recognition are critical in preventing respiratory complications and failure. X SAFE DOSAGE (SBAR) format to communicate what further care Brittany Long needs. pain, shortness of breath, weakness, slurring of speech) occurs. hhulsey6. She has been taking small amounts I administered more fluids and individual for whom it was prescribed. SpO2: 99%. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. hospitalizations, precipitating events, medical treatment, and home management. Student exploration Graphing Skills SE Key Gizmos Explore Learning. This is correcevery opportunity to provide patient education. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. and BP now prescribed regular folic acid supplement. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . She was brought into the ED during the night
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