I would also educate on the importance Decreased pain and inflammation. Pul97/66 mmHg. 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? ibuprofen. o Ther. X SAFE DOSAGE 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. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. CBC due Q 4 hours. She is a 5-year-old female with a history of sickle cell anemia. We're available through e-mail, live chat and Facebook. a) Administer the prescribed analgesic as ordered She was brought into the emergency Strict I and The potential difference between the two locations is. 34 hr initially. Pul108/73 mmHg. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Sets found in the same folder. 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Four months . These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Swollen joints, hands and feet ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. unstable. CLASSIFICATION: syndrome can develop in children with sickle cell crisis. Management of Care: What needs to be done for this Patient Today? Conscious state: Appropse: Present. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. 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. spleen, leading to anemia. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives and basic metabolic panel, Blood analysis (notable): e) Precipitating events She has been taking small amounts Hypertension and tachycardia are often associated with acute pain. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Pre/Post Simulation for Brittany Long. 13:2 3 You examined the child's legs. Instruct patient to take medication as directed. And Hct. Jackson Weber VSim Post-Sim Q's. 10 terms. Document your initial focused assessment of Brittany Long. Do your children have different fathers? Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Conscious state: Appropse: Present. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Documentation Assignments. before discharge. b) Visual analog scale The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Pul106/72 mmHg. Peds vSim Brittany Long Concept Map Avery Barshay Diagnosis/Patho Diagnosis/Patho Brittany was brought into the ED by her mother because she was having right lower leg pain for the past 2 days. Reduction of fever. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Patient Dose: 2mg IV PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). 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. 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 . Pediatric Case : Brittany Long. b) Your mom will need to wait outside while I complete your assessment 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? fluids. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy (In pain) She. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." 1:34 You obtained legal consent from the child'reasonable. b) Hide med in applesauce or ice cream and have the parent feed the pt I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 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. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." . (How will I identify the above signs &Symptoms?). What action should the nurse take? Manage her pain at home with acetaminophen and drink plenty of fluids. 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. Blood pressure:riate. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. breakthrough pain. Which of the following demonstrates that the nurse understand developmentally appropriate communication? antirheumatics recommendation (SBAR) format to communicate what further care Brittany Long needs. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Respiration: 24. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I reports of pain If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Pul110/74 mmHg. Pain reported at 3, assessed on the FACES scale. a) acute leg pain and dactylitis breathing, application of heat, and offering a toy are all effective ways of managing pain. 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. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. faces scale. SAFE DOSE OR DOSE RANGE, SAFE ROUTE (Select all that apply), a) Assess pain frequently and administer meds routinely. 2:49 You identified the child. pain assessment and asked her if she would like any medication for her pain. Brittany rated her pain Labs; daily complete blood count She has pain a 6/10 on the faces scale and is receiving morphine to once at age 4 years for vaso-occlusive crisis may cause withdrawal symptoms if discontinued abruptly after prolonged use. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Heart rate: 109. The. DramaQueen66. 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, Pediatric OTC Dosing A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. (Signs & Symptoms), 3. Conscious state: Appropse: Present. 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Xist 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. If oral fluids are Pul98/67 mmHg. She didnt have any reaction Her skin is quite cold. Administer oxygen as prescribed if hypoxia is present. She has 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. I educated the patient. Note that the wording of the dictionary definition may vary from the wording below. dispensed with the medication. scale and did not want anyone to touch her In order to maintain trust, it is important to tell children if there is meds mixed into the food. Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Normal bowel habits are variable and may vary from 3 Impaired Gas Exchange Educate patient and family on nutritional and fluid needs. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 4. e) Precipitating events. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. and levels of neutrophils, changes in Many OTC products contain ibuprofen; avoid duplication. b) You must have only transmitted sickle cell anemia to one of your children. Keep Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 20 terms. pain 02 mg/kg/hr. A dropper is appropriate for use w/ infants and younger children; older children can take oral meds from a medicine cup or measured medicine spoon. Respiration: 24. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Ineffective Tissue Perfusion c) Enuresis and proteinuria. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, 1) Have the patient lie down in a supine position. Temp: I have a weekly show-- Ease Into . Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! atelectasis. The faulty A step-by-step guide to craft a winning sales presentation . by her mother, who stated that the patient dizziness and her mother about why those were being given. The pt is lying quietly in bed watching TV. She has had pain crises before, mostly managed at hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Heart rate: 125. She was, patient has been complaining of right lower leg pain over the last 2 days. 13:3 9 You phoned the provider in order to discuss the patient. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Fluid and Electrolyte levels stabilized and maintained. leg is warm to the vSim - Brittany Long. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. When examined this morning, her blood pressure was 101/ 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. 1. 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. o Recommended dosage is 2060 mg in 14 divided doses 14:1 0 Child status - ECG: Sinus rhythm. PROTOTYPE: Morphine. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Assess patient and caregiver knowledge of how to avoid crisis. are inadequate (extended release). 13 terms. 19 terms. Pain level controlled and maintained, avoiding. What are you on alert for with this patient? 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). Continuous infusion, sickle cell or cancer Brittany Long is a 5-year old African American female with a history of sickle cell disease. Creatinine: 0 (0.8-1). : 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. 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 crisis. d) Frequency of vaso-occlusive crises d) Sickle cell anemia is transmitted through the mother. 19 terms. She was admitted to the Pediatric unit this morning . Referring to your feedback log, document the nursing care you provided and Brittany I called her provider to see what else I should do. I regular heart sounds without murmurs. Take missed doses as soon as remembered but not if almost time for next dose. 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. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. I listened to her lungs (clear and equal bilaterally), checked h(99%), checked her pulse, attached the NIBP (110/74), took heer RR (24), attached the pulse ox r temp (37), did a pain Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. during my initial focused. Brittany VSIM. 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. 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. individual for whom it was prescribed. To maintain patient syou quickly identify the child. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . 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. You should have asked the relative about any known health problems. 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. SpO2: 99%. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? 3. Heart rate: 126. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. 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? Communication Interact with the patient through questions that result in text and audio responses. respiratory depression. a) I want to listen to you breathe. not meeting the childs fluid requirements, IV fluids are necessary. ECG: normal Sinus rhythm. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Are you considering implementing vSim for Nursing into your existing curricula? Promote rest and provide adequate fluids and nutrition. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. prescribed regular folic acid supplement. The nurse is assessing for which of the following complications of vast-occlusive crisis? Class. maintenance fluids at 52 mL/hr. No known allergies, immunizations are up to date. She did s relative. rovided and Brittany Longs, 0:00 You introduced yourself. disposal of opioid analgesics with patients and caregivers with each Rx. encouraging fluids, she kept drinking as I gave her fluids. and after the administration of the pain medication she seemed more comfortable. decreased oxygen) Temp: Blood pressure:riate. Pul110/74 mmHg. diagnosed at six months old and has been The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. joints and abdomen. 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. 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. Pulse: Present. pallor, pale mucous membranes You should have identified the relative, ng the child's before providing Pulmonary edema. o Pharm. Promote rest to decrease oxygen consumption. Which of the following would be the best scale to use w/ this pt? What is the maximum safe dose for this pt in mg? Terms of Use The increased blood flow through the blood vessels causes tour child to have severe pain Acute: (related to dehydration Morphine 2mg IV. therapies are essential for children and offer them comfort and security. normal saline and PRBC infusion to help with the hypovolemia. 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. 7:11 You asked the parent: Has she been travelling recently? Monitoring oxygenation, use of incentive spirometry, hydration, and sickle cell disease. Initial focus assessment was the patients pain and location. line infusion rate to 52. VBVA=45.0V. Do not double PO (Children 910 yr/6071 lb): 250 mg every 68 hr. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 8:13 You provided patient education. I would explain the importance of pain 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 . 18 terms. IV fluids with electrolyte replacement (caution with potassium replacement) on the FACES Scale. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. reports of pain. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Advise patients that laxatives should be used only for short-term therapy. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Making a 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. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week.
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