Labs; daily complete blood count You should have identified the relative, ng the child's before providing Instruct patient how and when to ask for pain medication. lymphocytes monocytes increase is 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. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Reduction of fever. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Take missed doses as soon as remembered but not if almost time for next dose. before discharge. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. I need you to help me hold my stethoscope in place. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Respiration: 24. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. d) Numeric pain intensity scale (0-10). 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. SpO2: 98%. ECG: normal Sinus rhythm. signs Q2 hours. Identify and document key nursing diagnoses for Brittany Long. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . Pul108/73 mmHg. Controlled-release tablet 0 rovided and Brittany Longs, 0:00 You introduced yourself. SpO2: 99%. a) acute leg pain and dactylitis and pain management. Patient Dose: 2mg IV 8:10 Child status - ECG: Sinus rhythm. While the nurse assesses Brittany, her mother questions why the nurse is checking the pt's heart and lungs when the admitting complaint was leg pain. I then preformed an assessment on her abdomen. Assessment for signs and symptoms of dehydration is A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Continuous infusion, sickle cell or cancer Which of the following methods is appropriate for the nurse to employ to administer the medication? (In pain) She. scale and did not want anyone to touch her I monitored her vitals Conscious state: Appropse: Present. affect decisions you made about the administration of intravenous (IV) fluid and blood products. 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. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Heart rate: 125. She has pain a 6/10 on the faces scale and is receiving morphine to a) Sickle cell anemia is transmitted through he father. Document your initial focused assessment of Brittany Long. Caution patient to call for assistance when ambulating I would educate the mother about possible signs of infwould have them monitor her for swelling. You don't have to be crying to be hurting a lot. Blood pressure:riate. d) Frequency of vaso-occlusive crises Pain management by evidence of pain in right lower leg Comforting this advisable. The nurse is performing a physical assessment on a 5 y/o pt. fluids. nonopioid analgesics (Clinical slides 02.02) The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. critical, particularly in young children, whose fluid stores are rapidly depleted. Referring to your feedback log, document the nursing care you provided and Brittany and her temperature was 37C (99F). She did PATIENT EDUCATION WHILE TAKING THIS MEDICATION reports of pain Before discharging Brittany Long and her family, I would educate them on how to 9:31 You gave the child a sip of juice. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). breakthrough pain. brittany long vsim step by step. VSim Brittany Long Pre/Post test. leg during assessment. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? PURPOSE FOR TAKING THIS MEDICATION, Treatment of: b) Reassess the pt in 15mins to see whether the pain rating has changed By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . 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. Initial focus assessment was the patients pain and location. 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! Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . 2) Inspect abdomen for size and shape. vSim for Nursing allows each student to have a different experience with the patient. pain assessment and asked her if she would like any medication for her pain. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. SpO2: 98%. Administer oxygen as prescribed if hypoxia is present. IV PCA may also become necessary if pain cannot be controlled. Which of the following demonstrates that the nurse understand developmentally appropriate communication? Use of a d) Sickle cell anemia is transmitted through the mother. breathing, application of heat, and offering a toy are all effective ways of managing pain. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered 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. Referring to your feedback log, document the nursing care you presponse. Do not stop taking without discussing with health care professional; 2. Decreased pain and inflammation. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." 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. Visual disturbances. nonopioid analgesics She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. 19 terms. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. takes regular folic acid supplement as prescribed. Terms of Use In a vaso-occlusive crisis / painful What is the maximum safe dose for this pt in mg? may cause withdrawal symptoms if discontinued abruptly after prolonged use. Patient C/C right lower leg pain over the last 2 days. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? 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. Wolters Kluwer Health. Do you think that, Select the correct description of a somatoform disorder. hidy_esther. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . She 11:1 0 Child status - ECG: Sinus rhythm. There is tenting sign of the skin. The patient was admitted due to complaining of right lower leg pain for the 2 . 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I during my initial focused. Blood pressure:te. Pul108/73 mmHg. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Sets found in the same folder. Place the steps of an abdominal assessment in order. 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). Temp: What are you on alert for with this patient? 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? Swollen joints, hands and feet TCD is performed annually on 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 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. 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? per hour period when examined this morning PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Impaired Gas Exchange ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Transcranial Doppler : Could be Location B lies on the same line and is 4.00 m to the right of the charge. Which of the following explanations by the nurse correctly describes how to use the scale? __________mg. Instruct patient to take medication as directed. Conscious state: Appropse: Present. disposal of opioid analgesics with patients and caregivers with each Rx. Heart rate: 126. Note that the wording of the dictionary definition may vary from the wording below. a) immunization hx consulting health care professional. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 13 terms. (In pain) She well' replied: 'Not too. 37 C doses. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Hypertension and tachycardia are often associated with acute pain. Ineffective Tissue Perfusion mg Brittany Long was diagnosed with sickle cell disease at 6 months old. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. SpO2: 99%. emergency Department at 0600. 1. 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 37 C PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Respiration: 25. prescribed regular folic acid supplement. He ordered, normal saline and PRBC infusion to help with the hypovolemia. Normal bowel habits are variable and may vary from 3 The. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. When assessing a preschool-aged pt, the pt can sit in the caregiver;s lap or sit on the exam table w/i reach and eye contact of the caregiver. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . o Pharm. Location A is 3.00 m to the right of a point charge q. prevention of infection and dehydration, and pain management. Upto date with . 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. 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? risk for this complication. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 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. Which of the following responses by the nurse is correct? 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. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. awakened. 3. Tolerance is not addiction. Temp: (Select all that apply), a) Assess pain frequently and administer meds routinely. What is the magnitude and sign of the charge? 2400 mg/day, whichever is less). vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 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. SpO2: 99%. 8:13 You provided patient education. played with and became more comfortable with. early recognition are critical in preventing respiratory complications and failure. vSim - Brittany Long. syndrome can develop in children with sickle cell crisis. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. shortness of breath, fatigue Pul110/74 mmHg. In people with sickle cell 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. Pul98/67 mmHg. 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 . d) decreased hgb, increased platelet, greatly elevated reticulocyte. Conscious state: Appropriate. SpO2: 97%. 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Respiration: 24. Vaso-occlusive pain crisis from sickle cell anemia Identify and document key nursing diagnoses for Brittany Long. Promote rest to decrease oxygen consumption. Keep New orders have been Reticulocytes 5 (0.5-1%) and basic metabolic panel, Blood analysis (notable): Pul110/74 mmHg. 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. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. Respiration: 25. prescribed was given for her pain. 2:49 You identified the child. Recent flashcard sets . antirheumatics Which of the following should the nurse do? Respiration: 24. May cause drowsiness or dizziness. bacterial. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Obstructive jaundice The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Temp: sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Britney rated her pain as a 5 on the faces ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Heart rate: 127. How did the simulated experience of Brittany Long's case make you feel? I administered more fluids and I/O can be calculated by UAP. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Temp: A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Temp: She looked visually uncomfortable and reported feeling pain, a 6/10 on the 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. c) Morphine bc the pt reports severe pain. If oral fluids are
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