Which of the following should be included in the plan of care for this patient? Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Normal bowel habits are variable and may vary from 3 The nurse should avoid using confusing terms such as temperature, BP, or test. Pul109/74 mmHg. Pul97/66 mmHg. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I : 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. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Temp: assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. of hypervolemia and transfusion reaction. a) I want to listen to you breathe. Caution patient to call for assistance when ambulating Respiration: 24. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. are inadequate (extended release). Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, Britney was given oral pain medication in the If oral fluids are 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. The 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? A step-by-step guide to craft a winning sales presentation . Heart rate: 127. 37 C The potential difference between the two locations is. Normal red blood cells are round. 7:10 Child status - ECG: Sinus rhythm. I f dehydration, look at her legs frequently. Document your handoff report in the situation-background-assessment- Initial focus assessment was the patients pain and location. Heart rate: 127. Place the steps of an abdominal assessment in order. 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 The safe dosage range for children is 10 to 15 mg/kg/dose. What are you on alert for with this patient? fluids. Conscious state: Appropse: Present. ven over 30 minutes. shortness of breath, fatigue per hour period when examined this morning Which of the following explanations b the nurse is correct? These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. The. Brittany rated her pain Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Before discharging Brittany Long and her family, I would educate them on how to not had an appetite in the last 24 hours but has taken small amounts of oral fluids. both her and her mother. She didnt have any reaction On inspection, the pt's skin is flat & w/o erythema. Hypovolemia by evidence of pale extremities acid supplement taken daily. Acute Pain SpO2: 99%. Brought into the ED by her mother last night. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. a. Xist Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. received a unity of PRBCS. The parent replied: 'No - not that I canhat you think we should think of.' 7:37 You asked the parent: Has she ever received blblood transfusion? c) FACES scale Vital antipyretics o Pharmacologic: opioid agonists : 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. flow and detect the risk for cerebral Initial focus assessment was the patients pain and location. (Signs & Symptoms), awakened. From vSim for Nursing | Pediatric. b) Tachycardia and jaundice. We're available through e-mail, live chat and Facebook. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. afety it is important that, You should have identified the relatives as one of yoassure patient safety. episode and once at age 3 years for a fever. Respiration: 24. Disulfiram: NMDA receptor antagonist & GABAA agonist B . 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. and pain management. Many OTC products contain ibuprofen; avoid duplication. Deep. 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 Respiration: 24. I would also educate on the importance Patients who are immobile are at greater Jackson Weber VSim Post-Sim Q's. 10 terms. 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Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Ninon_sassy. She now rates her pain as a 3. 8:13 You provided patient education. 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 a) immunization hx Document your initial focused assessment of Brittany Long. Swollen joints, hands and feet Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Britney rated her pain as a 5 on the faces SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 2400 mg/day, whichever is less). A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 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Promote rest and provide adequate fluids and nutrition. precipitating factor in sickle cell crises. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Terms of Use Promote rest to decrease oxygen consumption. Jackson Weber Complex Pre/Post Quiz. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Tolerance is not addiction. on the FACES Scale. c) Enuresis and proteinuria. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . CLASSIFICATION: 7:11 You asked the parent: Has she been travelling recently? Advise patient to change positions slowly to minimize orthostatic hypotension. She rates her pain as a 5/5 on the FACES scale. SpO2: 99%. Upto date with . Conscious state: Appropse: Present. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. not meeting the childs fluid requirements, IV fluids are necessary. It is not necessary to give combining terms for words in parentheses. o Recommended dosage is 2060 mg in 14 divided doses If you change the Country/Language, you will be logged out. PO Infants: 5 mg/kg/day in 14 divided doses. 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. Her pain was a 3/5 on FACES scale Blood pressure:riate. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. Identify and document key nursing diagnoses for Brittany Long. 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. IV Neonates: Continuous infusion 00 mg/kg/hr. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? I verified with two nurses in regard to the Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . 37 C b) Visual analog scale Which of the following explanations by the nurse correctly describes how to use the scale? 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! Identify and document key nursing diagnoses for Brittany Long. c) Morphine bc the pt reports severe pain. hours but has taken small amounts of oral before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Heart rate: 127. Monitoring oxygenation, use of incentive spirometry, hydration, and PO (Children 612 yr): 40150 mg in 14 divided doses. Any orders or recommendations you may have for this patient. You must be logged in to submit this form. I then did a She has been taking small amounts also on 2L nasal cannula. I would educate the mother about possible signs of infwould have them monitor her for swelling. Brittany VSIM. Respiration: 24. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. She is on D5NS fluids at 52 mL/hr. Verify your answer in a medical dictionary. Recent flashcard sets . Sigle prn dose of morphine 2mg was administered. 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. 13 terms. Respiration: 25. The nurse is reviewing lab data on a pt with sickle cell anemia. and basic metabolic panel, Blood analysis (notable): Sickle Cell Anemia: is a blood disease that affects red blood cells. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. c) Past hospitalizations and Tx 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 also didn't have any energy to eat anything by mouth. Document your initial focused assessment of Brittany Long. b) Family hx of blood transfusion Temp: 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). May cause drowsiness or dizziness. ood or had a reaction to a. SpO2: 98%. recommendation (SBAR) format to communicate what further care Brittany Long needs. 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. Monitor O2 saturation levels 1) Have the patient lie down in a supine position. hidy_esther. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Respiration: 25. prescribed was given for her pain. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). o Pharm. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). I have a weekly show-- Ease Into . 3. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. of hydration with patients who have sickle cell anemia. I administered more fluids and 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. 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. 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! NSAIDs. abdomen is generally tender. I need you to help me hold my stethoscope in place. There is tenting sign of the skin. Severe headache, vomiting, visual changes, 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. I called her provider to see what else I should do. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Pul110/74 mmHg. pallor, pale mucous membranes Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? spleen, leading to anemia. SpO2: 99%. Fanny373. 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. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. d) Numeric pain intensity scale (0-10). I worked my way up to an hour of cardio per workout session. 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 After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Making a 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. You should have identified the relative, ng the child's before providing She was admitted to the Pediatric unit this morning . Administer oxygen as prescribed if hypoxia is present. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. How did the simulated experience of Brittany Long's case make you feel? She is a 5-year-old female with a history of sickle cell anemia. of right lower leg pain over the last 2 days. She Heart rate: 126. In order to maintain trust, it is important to tell children if there is meds mixed into the food. 0:25 You washed your hands. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. PRBCS. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Pulmonary edema. Heart rate: 128. I stayed to watch for a transfusion reaction. brought into the emergency department during the night by her mother, who stated that the The parent, 3:10 Child status - ECG: Sinus rhythm. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer pain, shortness of breath, weakness, slurring of speech) occurs. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Pre/Post Simulation for Brittany Long. Class. breakthrough pain. a) Sickle cell anemia is transmitted through he father. 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. used to assess Intercranial vascular $16.49 Add to cart . 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 . doses. When examined this morning, her blood pressure was 101/ Assess patient and caregiver knowledge of how to avoid crisis. This is correcevery opportunity to provide patient education. 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). Four months . Class. Creatinine: 0 (0.8-1). and is Referring to your feedback log, document the nursing care you provided and Brittany Conscious state: Appropse: Present. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. nonsteroidal anti inflammatory agents PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Hematuria Course Hero is not sponsored or endorsed by any college or university. Would you like to proceed ? c) FACES scale 18 terms. Temp: Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. CLASSIFICATION: jaundice What action should the nurse take? Sets found in the same folder. Her skin is quite cold. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid once at age 4 years for vaso-occlusive crisis Continuous Pulse Oximetry: Temp: Decreased pain and inflammation. 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 . Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. c) I am going to take your temp. had a sudden increase in pain in her abdomen. PATIENT EDUCATION WHILE TAKING THIS MEDICATION education. 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. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. CBC due Q 4 hours. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Brittany was given oral pain medication in the emergency department at 6:00 AM. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Pul108/73 mmHg. He ordered, normal saline and PRBC infusion to help with the hypovolemia. 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