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I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. c) Drinking to much water can trigger another crisis. It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Brittany was given oral pain medication in the emergency department at 6:00 AM. The nurse is assessing for which of the following complications of vast-occlusive crisis? She looked visually uncomfortable and reported feeling pain, a 6/10 on the Pediatric Case 7: Brittany Long (Core) Documentation Assignments. 9:10 Child status - ECG: Sinus rhythm. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. and basic metabolic panel, Blood analysis (notable): 37 C during my initial focused. 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. consulting health care professional. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Pain level controlled and maintained, avoiding. Conscious state: Appropriate. Pul109/74 mmHg. Hydration is essential to female with a history of sickle cell disease, and after the administration of the pain medication she seemed more comfortable. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. used to assess Intercranial vascular She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. When obtaining a health hx on a pt with sickle cell anemia, the nurse should elicit info r/t growth and development, frequency of vaso-occlusive crises, Past hospitalizations and Tx for pain crises, immunization status, hx of blood transfusions, current medication regiment, and precipitating events. Identify and document key nursing diagnoses for Brittany Long. I would also educate on the importance Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Strict I and pain, shortness of breath, weakness, slurring of speech) occurs. 1. You should have asked the relative about any known health problems. Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. d) Frequency of vaso-occlusive crises 13:3 9 You phoned the provider in order to discuss the patient. Pain management by evidence of pain in right lower leg Temp: referral to the pain team may also be helpful in SCD crises management. CLASSIFICATION: d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Administer oxygen as prescribed if hypoxia is present. Many OTC products contain ibuprofen; avoid duplication. Transcribed image text: Patient Introduction 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. PO Infants: 5 mg/kg/day in 14 divided doses. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 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? greenstickynotes. 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. dizziness IV PCA may also become necessary if pain cannot be controlled. She has had pain crises before, mostly managed at Visual disturbances. 2:49 You identified the child. 1:34 You obtained legal consent from the child'reasonable. of right lower leg pain over the last 2 days. d) Sickle cell anemia is transmitted through the mother. o Therapeutic: opioid analgesics Heart rate: 126. received a unity of PRBCS. 15:4 1 A patient handoff was performed. When examined this morning, her blood pressure was 101/ determine anemia state & if there is Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. 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? respiratory depression. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. prescribed was given for her pain. She rates her pain as a 5/5 on the FACES scale. Respiration: 15. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Ineffective Tissue Perfusion 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. Temp: 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. has been taking small amounts of oral fluids and continues to receive intravenous Advise patient that morphine is a drug with known abuse potential. CBC w/ dif : SHOULD be ordered to Conscious state: Appropse: Present. Your other child definitely carries the trait Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Heart rate: 109. Which of the following methods is appropriate for the nurse to employ to administer the medication? 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 nurse is reviewing lab data on a pt with sickle cell anemia. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. 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. Document your initial focused assessment of Brittany Long. vSim - Brittany Long. Observe for manifestations Respiration: 24. Pul110/74 mmHg. 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 . Tolerance is not addiction. 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. Pulmonary edema. c) FACES scale 19 terms. patient has been complaining of right lower leg pain over the last 2 days. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Protect it from theft, and never give to anyone other than the VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Antipyretic 5 mg/kg for 37 C hhulsey6. If oral fluids are We have noticed you are logged in to ${country}. brittany long complex vsim documentation. regular heart sounds without murmurs. 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. PO (Children 36 yr): 2060 mg in 14 divided doses. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . 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. for a vaso-occlusive crisis episode and once at age 3 years for a fever. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." a) FLACC scale avoid a sickle cell crisis in the future. Neutrophils and bans are bacterial. Document your initial focused assessment of Brittany Long. SAFE DOSE OR DOSE RANGE, SAFE ROUTE PROTOTYPE: Aspirin Hgb is most recently 7 g/dL. Respiration: 24. . d)Enuresis and proteinuria. Child Life can assist in making the child comfortable and regulating anxiety levels. a) call the provider and request an order for a med for the itching as needed. She is on D5NS fluids at 52 mL/hr. Naltrexone: -opioid receptor antagonist that reduces the. Pul98/67 mmHg. $16.49 Add to cart . 2. 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? A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Place the steps of an abdominal assessment in order. 26% line infusion rate to 52. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. This was, 2:10 Child status - ECG: Sinus rhythm. e) Precipitating events. 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. Blood pressure:riate. The nursing care for Brittany Long began with obtaining a set of vitals. Pul110/74 mmHg. Labs; daily complete blood count Signs of stroke i. Blood pressure:riate. Location A is 3.00 m to the right of a point charge q. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. VBVA=45.0V. b) Reassess the pt in 15mins to see whether the pain rating has changed 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 19 terms. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. her pain as a three. Stabilizing fluid levels to assist in relieving pain. Identify and document key nursing diagnoses for Brittany Long. risk for this complication. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: signs Q2 hours. Use preservative-free formulation. Would you like to proceed ? VS can be monitored and reported by the UAP. Heart rate: 127. New orders have been. Heart rate: 126. brittany long vsim step by step. Conscious state: Appropse: Present. electrolyte imbalance and dependence. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation Referring to your feedback log, document the nursing care you provided and Brittany Long. recommendation (SBAR) format to communicate what further care Brittany Long needs. 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 Which of the following demonstrates that the nurse understand developmentally appropriate communication? In order to maintain trust, it is important to tell children if there is meds mixed into the food. 37 C 2. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). (In pain) She. Assess dehydration status via CBC, Urinalysis and strict I/O. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Conscious state: Appropriase: Present. pallor, pale mucous membranes splenomegaly Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 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Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Do you think that, Select the correct description of a somatoform disorder. Brought into the ED by her mother last night. Britney rated her pain as a 5 on the faces Reticulocytes 5 (0.5-1%) She also did n't have any energy to eat anything by mouth . and educated the mother about signs of a reaction. management so it does not turn into a crisis. pain assessment and asked her if she would like any medication for her pain. Initial focus assessment was the patients pain and location. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 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 precipitating factor in sickle cell crises. She 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. She also didn't have any energy to eat anything by mouth. 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The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Transcranial Doppler : Could be Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. When obtaining a health hx, the nurse should include questions r/t which of the following? PURPOSE FOR TAKING THIS MEDICATION, Treatment of: hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Patient C/C right lower leg pain over the last 2 days. Children should never be force to change into a gown. (How will I identify the above signs &Symptoms?). 2) Inspect abdomen for size and shape. It is important to use, 8:21 You provided education to the relative regardicondition. The potential difference between the two locations is. 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! ECG: normal Sinus rhythm. Temp: critical, particularly in young children, whose fluid stores are rapidly depleted. The Family history of sickle cell The breath sounds are clear and equal bilaterally.