She did Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Blood pressure:riate. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? of infection and dehydration, and pain management. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Pul110/74 mmHg. SpO2: 99%. Acute Pain IV Neonates: Continuous infusion 00 mg/kg/hr. blood and then administered it. Which of the following would be the best response by the nurse? Respiration: 25. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. She also didn't have any energy to eat anything by mouth. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . b) Hide med in applesauce or ice cream and have the parent feed the pt NS and PRBCs. : 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. Thus, the maximum safe dose is 240 mg. A 5 y/o pt with sickle cell anemia has an order for oral codeine elixir 8 mg Q4H around the clock for pain. Temp: PROTOTYPE: Aspirin Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without 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. hours but has taken small amounts of oral Morphine 2mg IV. Temp: Use preservative-free formulation. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . 6a Daily Routine. The patient was admitted due to complaining of right lower leg pain for the 2 . 2. Conscious state: Appropriate. prescribed regular folic acid supplement. 15 x 16 = 240. 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. Document your initial focused assessment of Brittany Long. Creatinine: 0 (0.8-1). Transcranial Doppler : Could be dispensed with the medication. Making a purchase. Class. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 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. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Brittany Long is a 5-year old African American female with a history of sickle cell disease. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: proceeded to ask where her pain was and she responded, my tummy, encouraged PO fluids and she drank some. 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. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. I would explain the importance of pain PO (Children 612 yr): 40150 mg in 14 divided doses. Background: Brittany Long has a history of sickle cell anemia being treated with a folic abdomen is generally tender. (Signs & Symptoms), awakened. Impaired Gas Exchange Heart rate: 126. Fluid and Electrolyte levels stabilized and maintained. Blood pressure:riate. Respiration: 24. Skip to document. I don't think so.' llergies? The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. Child Life can assist in making the child comfortable and regulating anxiety levels. Heart rate: 109. unstable. given. X SAFE DOSAGE She now rates her pain as a 3. I worked my way up to an hour of cardio per workout session. Examined the leg and it was warm. Heart rate: 126. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Conscious state: Appropriase: Present. Blood pressure:riate. Describe the actions you felt went well in this scenario. Temp: 37.3. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. Heart rate: 127. No known allergies, immunizations are up to date. consulting health care professional. Family history of sickle cell : 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. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. 240 This is reasonable. a) Acute leg pain and dactylitis. a) FLACC scale You should have identified the relative, ng the child's before providing Acute chest She has pain a 6/10 on the faces scale and is receiving morphine to 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 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. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . He ordered, normal saline and PRBC infusion to help with the hypovolemia. Pul108/73 mmHg. 26% 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I I need you to help me hold my stethoscope in place. slurred speech, What Assessments will focus on for this patient? 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. 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. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. encouraging fluids, she kept drinking as I gave her fluids. Britney was given oral pain medication in the A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. rovided and Brittany Longs, 0:00 You introduced yourself. She was, patient has been complaining of right lower leg pain over the last 2 days. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer 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. Document your initial focused assessment of Brittany Long. regular heart sounds without murmurs. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Long-term therapy may cause I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Her c) Past hospitalizations and Tx I need you to help me hold my stethoscope in place. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Document your initial focused assessment of Brittany Long. 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 VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. 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. intravenous maintenance fluids at 52 milliliters Jackson Weber Complex Pre/Post Quiz. The patient was diagnosed with sickle cell anemia and was in a Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. 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). Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. 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. 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. per hour period when examined this morning Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 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. c) Morphine bc the pt reports severe pain. Course Hero is not sponsored or endorsed by any college or university. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. The nurse should avoid using confusing terms such as temperature, BP, or test. She rates her pain as a 5/5 on the FACES scale. The parent replied: 'No. Instruct patient to take medication as directed. Visual disturbances. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Promote rest to decrease oxygen consumption. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Monitor her 02 sat and keep above 94%. Respiration: 24. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. How did the simulated experience of Brittany Long's case make you feel? She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. provided education to Decreased pain and inflammation. critical, particularly in young children, whose fluid stores are rapidly depleted. female with a history of sickle cell disease, A step-by-step guide to craft a winning sales presentation . Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . 19 terms. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Hydration is essential to 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. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. SpO2: 98%. She was IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Blood pressure:te. a) Sickle cell anemia is transmitted through he father. vSim - Brittany Long. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) I also started incorporating more strength training into my gym routine. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. North Carolina State University. Pain management by evidence of pain in right lower leg a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Pain reported at 3, assessed on the FACES scale. d) Frequency of vaso-occlusive crises joints and abdomen. 37 C 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. She has Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Britney long is a 5 year old African American The Ineffective Tissue Perfusion New orders have been. CLASSIFICATION: You should have asked the relative about any known health problems. of hydration with patients who have sickle cell anemia. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. bacterial. VBVA=45.0V. viral. home with acetaminophen and ibuprofen. I SpO2: 98%. To maintain patient syou quickly identify the child. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. 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? headache Which of the following explanations b the nurse is correct? Over time, the red blood cells become rigid and shaped like crescent moons or sickles. b) Family hx of blood transfusion a) immunization hx Cross), 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), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Give Me Liberty! Wolters Kluwer Health. 3. Monitor her pain levels. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Monitor O2 saturation levels hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. What is the maximum safe dose for this pt in mg? Pediatric Case 7: Brittany Long (Core) 1. This was not part of your orders here. A step-by-step guide to craft a winning sales presentation . 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? individual for whom it was prescribed. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. respiratory depression. (Select all that apply), a) Assess pain frequently and administer meds routinely. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. . Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device tired. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. The potential difference between the two locations is. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. The spleen is enlarged, Communication Interact with the patient through questions that result in text and audio responses. lymphocytes monocytes increase is Temp: Reticulocytes 5 (0.5-1%) management so it does not turn into a crisis. kuuleinani1102. Blood pressure:riate. Assessment for signs and symptoms of dehydration is 19 terms. 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. On inspection, the pt's skin is flat & w/o erythema. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. SpO2: 98%. When examined this morning, her blood pressure was 101/ d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. PRBCS. 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. a left (bacterial) or right shift (viral) Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." 3. This was part of your order. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). o Pharm. dizziness Patients who are immobile are at greater 7:10 Child status - ECG: Sinus rhythm. (Abnormal) rapidity of the heart ____________________________________. The faulty 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. 14:1 0 Child status - ECG: Sinus rhythm. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. decreased oxygen) IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. a) Administer the prescribed analgesic as ordered 4. s relative. leg during assessment. 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 and basic metabolic panel, Blood analysis (notable): hidy_esther. IF you have four children, one or 25% will have sickle cell anemia. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). of hypervolemia and transfusion reaction. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Her skin is quite cold. Pul106/73 mmHg. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. d) Anemia and hypotension. Temp: I called her provider to see what else I should do. Controlled-release tablet 0 Temp: 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 pain crisis. prescribed was given for her pain. 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 Course Hero is not sponsored or endorsed by any college or university. Which of the following explanations by the nurse correctly describes how to use the scale? I then did a Bp is trending low, she has normal saline running at 320 ml/hr and has recently poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids both her and her mother. Respiration: 15. c) Use a dropper to place med in back of the pt's throat Heart rate: 127. SpO2: 99%. 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. 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? maintenance fluids at 52 mL/hr. Brittany Long was diagnosed with sickle cell disease at 6 months old. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . 18 terms. 13:3 9 You phoned the provider in order to discuss the patient. Hgb is most recently 7 g/dL. a) Acute leg pain and dactylitis. The nurse is performing a physical assessment on a 5 y/o pt. Conscious state: Appropse: Present. every 34 hr, maximum: 15 mg/dose. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 37 C proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ CLASSIFICATION: occlusive crisis. Assess patient and caregiver knowledge of how to avoid crisis. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. This was, 2:10 Child status - ECG: Sinus rhythm. Children should never be force to change into a gown. ood or had a reaction to a. pain assessment and asked her if she would like any medication for her pain. Patient C/C right lower leg pain over the last 2 days. Are you considering implementing vSim for Nursing into your existing curricula? Pediatric Case 7: Brittany Long (Core) Documentation Assignments. PROTOTYPE: Morphine. o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). 37 C Normal red blood cells are round. and levels of neutrophils, changes in d) Numeric pain intensity scale (0-10). 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? In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. anemia or sickle cell trait Pulmonary edema. PDA Closure What are you on alert for with this patient? Document your . flow and detect the risk for cerebral Pul109/74 mmHg. 1. Document the patient history you obtained for Brittany Long.
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