of hydration with patients who have sickle cell anemia. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. of hypervolemia and transfusion reaction. SpO2: 98%. Course Hero is not sponsored or endorsed by any college or university. 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? shortness of breath, fatigue avoid a sickle cell crisis in the future. If that is not sufficient to manage their pain, they may require morphine for Recent flashcard sets . It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. CBC due Q 4 hours. had a sudden increase in pain in her abdomen. : 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. Temp: poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 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. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. and pain management. for a fever. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. hhulsey6. Strict I and 37 C Her skin is quite cold. prescribed was given for her pain. Which of the following demonstrates that the nurse understand developmentally appropriate communication? M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Keep Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Temp: Conscious state: Appropriase: Present. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. also on 2L nasal cannula. nonsteroidal anti inflammatory agents Her pulse measured 160bpm, her respirations were 34, and her blood VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? d) Frequency of vaso-occlusive crises Brittany VSIM. arcoca. 0:25 You washed your hands. arcoca . vascular accident (CVA). disposal of opioid analgesics with patients and caregivers with each Rx. Hgb is most recently 7 g/dL. She rates her pain as a 5/5 on the FACES scale. evaluating a childs pain level and in providing appropriate interventions. Vital Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. emergency Department at 0600. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Britney long is a 5 year old African American Blood pressure:riate. e) Precipitating events. are inadequate (extended release). Temp: may cause withdrawal symptoms if discontinued abruptly after prolonged use. The nurse is teaching Brittany how to use the FACES scale to rate pain. Blood pressure:riate. Document your initial focused assessment of Brittany Long. CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. flow and detect the risk for cerebral Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 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? She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. vSim - Brittany Long. Instruct patient how and when to ask for pain medication. 13:3 9 You phoned the provider in order to discuss the patient. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. I then preformed an assessment on her abdomen. Blood pressure:te. IV fluids with electrolyte replacement (caution with potassium replacement) She is asleep but is responsive when 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. before discharge. She has been taking small amounts Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. The pt is lying quietly in bed watching TV. intake (68 full glasses/day), and increasing mobility. Assess dehydration status via CBC, Urinalysis and strict I/O. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Acute pain R/T sickle cell disease AEB vaso-occlusive crisis in right leg: The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. d) Sickle cell anemia is transmitted through the mother. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? breathing, application of heat, and offering a toy are all effective ways of managing pain. leg during assessment. 7:10 Child status - ECG: Sinus rhythm. Educate patient and family on nutritional and fluid needs. TCD is performed annually on 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? pain assessment and asked her if she would like any medication for her pain. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. New orders have been. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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Conscious state: Appropse: Present. 0 mg/kg every 12 hr. 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. I do about 40 minutes of it five times a week. Brittany was given oral pain medication in the emergency department at 6:00 AM. Britney was given oral pain medication in the 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. a) FLACC scale 6a Daily Routine. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. a) Sickle cell anemia is transmitted through he father. Signs of stroke i. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." PO (Children 612 yr): 40150 mg in 14 divided doses. A step-by-step guide to craft a winning sales presentation . Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. I f dehydration, look at her legs frequently. Pain reported at 3, assessed on the FACES scale. The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE I monitored her vitals Neutrophils and bans are bacterial. b) Family hx of blood transfusion Student exploration Graphing Skills SE Key Gizmos Explore Learning. Morphine 2mg IV given as 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. 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 Conscious state: Appropse: Present. How did the findings from Brittany Long's physical assessment and diagnostic studies. Labs; daily complete blood count a) Choose the face that looks like how you feel inside. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Find all solutions of the following equation. line infusion rate to 52. Conscious state: Appropse: Present. Identify and document key nursing diagnoses for Brittany Long. 15:4 1 A patient handoff was performed. nonopioid analgesics a) call the provider and request an order for a med for the itching as needed. has been complaining of right lower leg pain o Pharm. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. The parent ; 7:32 You asked the parent: Is there anything else tknow? School Herzing University; Course Title PN 124; Uploaded By hana254830. 6:22 You asked the child how long she had pain for. 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 . In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 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. 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. What action should the nurse take? Which of the following would be the best scale to use w/ this pt? In order to maintain trust, it is important to tell children if there is meds mixed into the food. Brittany used to assess Intercranial vascular Four months . 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). By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . The nurse is performing a physical assessment on a 5 y/o pt. a) immunization hx The padon't think so.' rent replied: 'No. She is asleep but is responsive when awakened. fluids. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Family history of sickle cell Blood pressure:riate. The patient was diagnosed with sickle cell anemia and was in a 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, kuuleinani1102. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Temp: 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? You should have asked the relative about any known health problems. Pul110/74 mmHg. Pul108/73 mmHg. encouraged PO fluids and she drank some. PDA Closure This was part of your order. Do your children have different fathers? Wolters Kluwer Health. I intravenous maintenance fluids at 52 milliliters Promote rest and provide adequate fluids and nutrition. Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Your other child definitely carries the trait IF you have four children, one or 25% will have sickle cell anemia. Do not stop taking without discussing with health care professional; Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. DramaQueen66. 37 C 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 Neutrophils and bans are Timely pain management. NS and PRBCs. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. 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. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. education. on the FACES Scale. SpO2: 99%. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 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! The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. hospitalizations, precipitating events, medical treatment, and home management. 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. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation Tolerance is not addiction. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? . c) tachycardia and jaundice Examined the leg and it was warm. electrolyte imbalance and dependence. 1. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Creatinine: 0 (0.8-1). She didnt have any reaction per hour period when examined this morning Hematuria The parent, 3:10 Child status - ECG: Sinus rhythm. 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. I stayed to watch for a transfusion reaction. a) acute leg pain and dactylitis Blood pressure:riate. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. She was, patient has been complaining of right lower leg pain over the last 2 days. CLASSIFICATION: Bp is trending low, she has normal saline running at 320 ml/hr and has recently tired. North Carolina State University. 8:10 Child status - ECG: Sinus rhythm. Over time, the She has been hospitalized twice, once at age 4 years Which of the following would be the best response by the nurse? Use preservative-free formulation. 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. episode and once at age 3 years for a fever. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). If you change the Country/Language, you will be logged out. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. priapism has been taking small amounts of oral fluids and continues to receive intravenous Respiration: 24. Decreased pain and inflammation. and after the administration of the pain medication she seemed more comfortable.
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