SpO2: 99%. slurred speech, What Assessments will focus on for this patient? 15:4 1 A patient handoff was performed. Vital When obtaining a health hx, the nurse should include questions r/t which of the following? There is tenting sign of the skin. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Pulmonary edema. of right lower leg pain over the last 2 days. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). DramaQueen66. A step-by-step guide to craft a winning sales presentation . b) Tachycardia and jaundice. episode and once at age 3 years for a fever. Situation: Brittany long is a 5-year-old African American female who has a history of It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Pain reported at 3, assessed on the FACES scale. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. a) I want to listen to you breathe. It is not necessary to give combining terms for words in parentheses. Normal red blood cells are round. Observe for manifestations I then did a acid supplement taken daily. precipitating factor in sickle cell crises. breakthrough pain. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Britney was given oral pain medication in the The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Severe pain, usually in bones Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Child Life can assist in making the child comfortable and regulating anxiety levels. 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Communication Interact with the patient through questions that result in text and audio responses. Respiration: 25. 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. Patient Dose: 2mg IV 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet regular heart sounds without murmurs. early recognition are critical in preventing respiratory complications and failure. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? fluids. Recent flashcard sets . What would be the most appropriate med for the nurse to administer? Heart rate: 126. Monitor and note changes in level of consciousness, reports of headache, dizziness, Britney rated her pain as a 5 on the faces Four months . I f dehydration, look at her legs frequently. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Finish the reading attached below and complete the | Chegg.com PO (Children <3 yr): 1040 mg in 14 divided doses. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . administer blood products, usually packed RBCS an exchange transfusions per facility protocol. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 37 C Jackson Weber VSim Post-Sim Q's. 10 terms. Respiration: 24. Conscious state: Appropriate. of hydration with patients who have sickle cell anemia. 37 C I monitored her respiratory rate for any 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. Heart rate: 126. Blood pressure:riate. Conscious state: Appropse: Present. sickle cell crisis. Neutrophils and bans are bacterial. 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! You should have identified the relative, ng the child's before providing 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. b) Anemia and hypotension She has been hospitalized twice, once at age 4 years S: This is Brittany Long. The potential difference between the two locations is. encouraged PO fluids and she drank some. 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. diagnosed at six months old and has been Temp: Brittany Long Vsim/ Broward College - NUR 250LBrittanyLongVsim - Stuvia 10:1 0 Child status - ECG: Sinus rhythm. Pul98/67 mmHg. I do about 40 minutes of it five times a week. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. PO Infants: 5 mg/kg/day in 14 divided doses. 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. Document your initial focused assessment of Brittany Long. and pain management. . a. Xist Monitor her pain levels. SpO2: 97%. 37 C Student exploration Graphing Skills SE Key Gizmos Explore Learning. Comforting this advisable. Dehydration is often a Making a purchase. per hour period when examined this morning Blood pressure:riate. temperature was 37 Celsius she now rates She also did n't have any energy to eat anything by mouth . She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Pre/Post Simulation for Brittany Long. Neutrophils and bans are Class: macrolide encouraging fluids, she kept drinking as I gave her fluids. Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. Advise patients that laxatives should be used only for short-term therapy. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) o Ther. The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health patient has been complaining of right lower leg pain over the last 2 days. Conscious state: Appropse: Present. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 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 A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. and educated the mother about signs of a reaction. 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. Conscious state: Appropriase: Present. Which of the following responses by the nurse is correct? She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Referring to your feedback log, document the nursing care you provided and Brittany Hgb is most recently 7 g/dL. Assessment for signs and symptoms of dehydration is 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: Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis. Acute Pain unstable. Do not double syndrome can develop in children with sickle cell crisis. 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. Creatinine: 0 (0.8-1). 6a Daily Routine. May cause drowsiness or dizziness. Impaired Gas Exchange Class. d)Enuresis and proteinuria. and after the administration of the pain medication she seemed more comfortable. She has been hospitalized twice, PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Respiration: 24. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Making a department during the night by her mother, who stated that the patient has been complaining From vSim for Nursing | Pediatric. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. What are you on alert for with this patient? The right lowertouch. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or 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. viral. The parent, 3:10 Child status - ECG: Sinus rhythm. Many OTC products contain ibuprofen; avoid duplication. Verify your answer in a medical dictionary. Monitoring oxygenation, use of incentive spirometry, hydration, and developmentally appropriate pain scale and assessment of pain behaviors are essential in maintenance fluids at 52 mL/hr. Hct: 29 (40-45%) Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. her pain as a three. 11:1 0 Child status - ECG: Sinus rhythm. 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. over the last 2 days. PROTOTYPE: Morphine. Heart rate: 126. Her skin is quite cold. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every nonopioid analgesics Respiration: 24. lymphocytes monocytes increase is 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 Temp: This was not part of your orders here. Transcranial Doppler : Could be 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? and levels of neutrophils, changes in She was admitted to the Pediatric unit this morning . assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. 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. for a fever. 37 C Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health anemia or sickle cell trait 2. B: She came in with right lower leg pain, and that has since been stabilized, but she has 1:34 You obtained legal consent from the child'reasonable. Advise patient that morphine is a drug with known abuse potential. Hgb 9 (13.5-17) NURS 3440 (NURS3440) Institution. Brittany Long vSim by Meghan Simons - prezi.com Class. Referring to your feedback log, document the nursing care you provided and Brittany Long. Respiration: 24. faces scale. You must be logged in to submit this form. Temp: 240 o Recommended dosage is 2060 mg in 14 divided doses not meeting the childs fluid requirements, IV fluids are necessary. intake (68 full glasses/day), and increasing mobility. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. PATIENT EDUCATION WHILE TAKING THIS MEDICATION 1) Have the patient lie down in a supine position. Pediatric Case : Brittany Long. Normal bowel habits are variable and may vary from 3 IV Neonates: Continuous infusion 00 mg/kg/hr. 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 . 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. Blood pressure:riate. 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I assessed her IV, asked for name and date of birth, and Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). I monitored her respiratory rate for any, respiratory depression. provided education to Hypovolemia by evidence of pale extremities VS can be monitored and reported by the UAP. b) Hide med in applesauce or ice cream and have the parent feed the pt 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. Identify and document key nursing diagnoses for Brittany Long. And Hct. d) Frequency of vaso-occlusive crises Course Hero is not sponsored or endorsed by any college or university. : 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. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth On inspection, the pt's skin is flat & w/o erythema. occlusive crisis. 13 terms. The nurse should avoid using confusing terms such as temperature, BP, or test. Pul108/73 mmHg. Promote rest and provide adequate fluids and nutrition. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. prevent further VOC and complications of SCD and to provide relief of pain. a) Acute leg pain and dactylitis. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia 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. I SpO2: 98%. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Which of the following would be the best scale to use w/ this pt? 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 . 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? I worked my way up to an hour of cardio per workout session. 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 Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options Pul109/74 mmHg. During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. Describe the actions you felt went well in this scenario. The spleen is enlarged, No known allergies, immunizations are up to date. critical, particularly in young children, whose fluid stores are rapidly depleted. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). decreased oxygen) Which of the following would be the best response by the nurse? She was Signs of stroke i. d) Frequency of vaso-occlusive crises She is a 5-year-old female with a history of sickle cell anemia. Conscious state: Appropse: Present. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. Temp: Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Stabilizing fluid levels to assist in relieving pain. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: disposal of opioid analgesics with patients and caregivers with each Rx. 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. 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. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. both her and her mother. 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. VSim Charlie Snow Complex Pre/Post Sim.
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