This was part of your order. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ PRBCS. Management of Care: What needs to be done for this Patient Today? The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. lymphocytes monocytes increase is You must be logged in to submit this form. arcoca. She was brought into the emergency Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 19 terms. 2) Inspect abdomen for size and shape. This was, 2:10 Child status - ECG: Sinus rhythm. The pt is lying quietly in bed watching TV. Describe the actions you felt went well in this scenario. Identify and document key nursing diagnoses for Brittany Long. Heart rate: 126. scale and did not want anyone to touch her You should have identified the relative, ng the child&apos;s before providing : 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. Skip to document. avoid a sickle cell crisis in the future. antirheumatics We have noticed you are logged in to ${country}. I have a weekly show-- Ease Into . Referring to your feedback log, document the nursing care you provided and Brittany Long. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. The Which of the following should the nurse do? Which of the following responses by the nurse is correct? poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids episode 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. Heart rate: 125. flow and detect the risk for cerebral a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. 13 terms. Fanny373. c) tachycardia and jaundice 8:13 You provided patient education. A step-by-step guide to craft a winning sales presentation . on the FACES Scale. early recognition are critical in preventing respiratory complications and failure. (Signs & Symptoms), awakened. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. 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. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Reticulocytes 5 (0.5-1%) PURPOSE FOR TAKING THIS MEDICATION, Treatment of: The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. regular heart sounds without murmurs. A step-by-step guide to craft a winning sales presentation . a left (bacterial) or right shift (viral) Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Respiration: 24. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Pediatric OTC Dosing She looked visually uncomfortable and reported feeling pain, a 6/10 on the and pain management. May cause drowsiness or dizziness. Long-term therapy may cause Deep. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: What is the magnitude and sign of the charge? 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. Assess dehydration status via CBC, Urinalysis and strict I/O. Normal red blood cells are round. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. The nurse is assessing for which of the following complications of vast-occlusive crisis? Hematuria Heart rate: 126. Making a purchase. 1) Have the patient lie down in a supine position. e) Precipitating events Jackson Weber Complex Pre/Post Quiz. d)Enuresis and proteinuria. CLASSIFICATION: o Pharmacologic: opioid agonists IV fluids with electrolyte replacement (caution with potassium replacement) PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. 19 terms. The patient was diagnosed with sickle cell anemia and was in a The. The nurse is performing a physical assessment on a 5 y/o pt. How did the simulated experience of Brittany Long's case make you feel? Sickle Cell Anemia: is a blood disease that affects red blood cells. education. 18 terms. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years PO (Children 612 yr): 40150 mg in 14 divided doses. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Brittany VSIM. Creatinine: 0 (0.8-1). Recent flashcard sets . Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? 0 mg/kg every 12 hr. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . PO (Children <3 yr): 1040 mg in 14 divided doses. Vital (In pain) She. Find all solutions of the following equation. 6a Daily Routine. c) FACES scale Course Hero is not sponsored or endorsed by any college or university. : 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. line infusion rate to 52. atelectasis. Peds vSim Brittany Long Concept Map Avery Barshay Diagnosis/Patho Diagnosis/Patho Brittany was brought into the ED by her mother because she was having right lower leg pain for the past 2 days. maintenance fluids at 52 mL/hr. VSim Brittany Long Pre/Post test. 9:03 You took a blood sample. PROTOTYPE: Aspirin (SBAR) format to communicate what further care Brittany Long needs. Reduction of fever. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. New orders have been. c) Past hospitalizations and Tx CBC w/ dif : SHOULD be ordered to decreased oxygen) Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Conscious state: Appropse: Present. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. and educated the mother about signs of a reaction. and is She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. Monitor and note changes in level of consciousness, reports of headache, dizziness, SpO2: 98%. c) Morphine bc the pt reports severe pain. acid supplement taken daily. Place the steps of an abdominal assessment in order. VS can be monitored and reported by the UAP. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. a) acute leg pain and dactylitis Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). o Recommended dosage is 2060 mg in 14 divided doses ven over 30 minutes. leg is warm to the Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. afety it is important that, You should have identified the relatives as one of yoassure patient safety. determine anemia state & if there is Pre/Post Simulation for Brittany Long. Heart rate: 127. Temp: 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 . Identify and document key nursing diagnoses for Brittany Long. antipyretics 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. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Pul110/74 mmHg. In a vaso-occlusive crisis / painful 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. Which of the following would be the best response by the nurse? prescribed regular folic acid supplement. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Use preservative-free formulation. (Signs & Symptoms), 3. 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). precipitating factor in sickle cell crises. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. vascular accident (CVA). black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest SpO2: 99%. I then preformed an assessment on her abdomen. and basic metabolic panel, Blood analysis (notable): Hypertension and tachycardia are often associated with acute pain. I Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. by her mother, who stated that the patient She did Circulating sickle cells are hemolysized by the. 7:11 You asked the parent: Has she been travelling recently? Pain reported at 3, assessed on the FACES scale. 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 . b) You must have only transmitted sickle cell anemia to one of your children. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. Temp: Discuss safe use, risks, and proper storage and disposal of opioid analgesics with patients and caregivers with each Rx. Keep vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. Monitor her pain levels. The safe dosage range for children is 10 to 15 mg/kg/dose. Heart rate: 107. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Pulse: Present. 3. Upto date with . SpO2: 97%. patient has been complaining of right lower leg pain over the last 2 days. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. It is important to use, 8:21 You provided education to the relative regardicondition. a. Xist A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. We're available through e-mail, live chat and Facebook. Brittany rated her pain Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. I listened to her lungs (clear and equal bilaterally), checked h(99%), checked her pulse, attached the NIBP (110/74), took heer RR (24), attached the pulse ox r temp (37), did a pain Jackson Weber VSim Post-Sim Q's. 10 terms. SpO2: 98%. her pain as a three. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Temp: Vaso-occlusive pain crisis from sickle cell anemia Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . 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. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Morphine 2mg IV. Blood pressure:riate. I need you to help me hold my stethoscope in place. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Background: Brittany Long has a history of sickle cell anemia being treated with a folic To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Heart rate: 127. Temp: I have given her morphine 2 mg IV Push and have also bolused 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. Pul108/73 mmHg. joints and abdomen. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). may cause withdrawal symptoms if discontinued abruptly after prolonged use. 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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. o Pharm. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: There is tenting sign of the skin. I do about 40 minutes of it five times a week. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. hhulsey6. 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. d) decreased hgb, increased platelet, greatly elevated reticulocyte. Electrolytes both her and her mother. SpO2: 98%. Respiration: 25. management so it does not turn into a crisis. She has gained 3 pounds since prenatal visit 1 week ago. Severe headache, vomiting, visual changes, Blood pressure:te. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. A. Somatization disorder - manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical, Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? 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? 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. Do not stop taking without discussing with health care professional; Strict I and received a unity of PRBCS. 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 anemia or sickle cell trait c) I am going to take your temp. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. hours but has taken small amounts of oral This new feature enables different reading modes for our document viewer. 10:1 0 Child status - ECG: Sinus rhythm. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options 2. Temp: 5 touch. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. NS and PRBCs. Course Hero is not sponsored or endorsed by any college or university. Normal red blood cells are round. Situation: Brittany long is a 5-year-old African American female who has a history of Signs of stroke i. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). She 2400 mg/day, whichever is less). 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. children ages 2 to 16 years who have Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, 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! b) Hide med in applesauce or ice cream and have the parent feed the pt Recent flashcard sets. and her mother about why those were being given. 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. per hour period when examined this morning d) Numeric pain intensity scale (0-10). ibuprofen. X SAFE DOSAGE 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I e) Precipitating events. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. 6:22 You asked the child how long she had pain for. 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 pallor, pale mucous membranes 37 C home with acetaminophen and ibuprofen. 15:4 1 A patient handoff was performed. . Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Document your initial focused assessment of Brittany Long. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Assessment for signs and symptoms of dehydration is 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! Any orders or recommendations you may have for this patient. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. 3. Note that the wording of the dictionary definition may vary from the wording below. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. Class: macrolide Promote rest to decrease oxygen consumption. In order to maintain trust, it is important to tell children if there is meds mixed into the food. a) I want to listen to you breathe. 19 terms. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Conscious state: Appropriase: Present. TCD is performed annually on 37 C By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. abdomen is generally tender. prevent further VOC and complications of SCD and to provide relief of pain. (How will I identify the above signs &Symptoms?). 18 terms. d) Sickle cell anemia is transmitted through the mother. Respiration: 24. Blood pressure:riate. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). 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. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? PO (Children 68 yr/4859 lb): 200 mg every 68 hr.