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. No known allergies, immunizations are up to date. b) Your mom will need to wait outside while I complete your assessment her pain as a three. PO (Children 36 yr): 2060 mg in 14 divided doses. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Vital Morphine 2mg IV given as (Signs & Symptoms), awakened. Do not double greenstickynotes. VBVA=45.0V. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . __________mg. Labs; daily complete blood count occlusive crisis. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet Initial focus assessment was the patients pain and location. fluids. Monitor and note changes in level of consciousness, reports of headache, dizziness, The pt is lying quietly in bed watching TV. 0:25 You washed your hands. Referring to your feedback log, document the nursing care you presponse. How did the simulated experience of Brittany Long's case make you feel? Advise patients that laxatives should be used only for short-term therapy. Normal red blood cells are round. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." : 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. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. has been complaining of right lower leg pain A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. 3. Temp: 5 touch. Dehydration is often a VSim Brittany Long Pre/Post test Flashcards | Quizlet e) Precipitating events. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Patients who are immobile are at greater vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT precipitating factor in sickle cell crises. and the abdomen is generally tender. Location A is 3.00 m to the right of a point charge q. I/O can be calculated by UAP. 3. priapism Assessment for signs and symptoms of dehydration is Fanny373. nonopioid analgesics d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. o Pharmacologic: opioid agonists Which of the following would be the best scale to use w/ this pt? mg Brittany Long was diagnosed with sickle cell disease at 6 months old. 37 C The child looked slightly This new feature enables different reading modes for our document viewer. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . o Pharm. Respiration: 24. every 34 hr, maximum: 15 mg/dose. times/day to 3 times/wk. Promote rest and provide adequate fluids and nutrition. Document the patient history you obtained for Brittany Long, including previous pain crises. and her mother about why those were being given. dispensed with the medication. referral to the pain team may also be helpful in SCD crises management. Respiration: 25. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Heart rate: 107. Document your handoff report in the situation-background-assessment- Brought into the ED by her mother last night. Blood pressure:riate. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 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. a) I want to listen to you breathe. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. c) I am going to take your temp. Jackson Weber VSim Post-Sim Q's. 10 terms. Identify and document key nursing diagnoses for Brittany Long. A step-by-step guide to craft a winning sales presentation . 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. acid supplement taken daily. Identify and document key nursing diagnoses for Brittany Long. hidy_esther. North Carolina State University. 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, Course Hero is not sponsored or endorsed by any college or university. over the last 2 days. She now rates her pain as a 3. 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 Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. 7:37 You asked the parent: Is there anything else tknow? Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex Family history of sickle cell a) Acute leg pain and dactylitis. Conscious state: Appropse: Present. vSim - Brittany Long Flashcards | Quizlet I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. PDA Closure Timely pain management. Electrolytes Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 37 C Respiration: 24. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. PO (Children 612 yr): 40150 mg in 14 divided doses. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). intravenous maintenance fluids at 52 milliliters therapies are essential for children and offer them comfort and security. Manage her pain at home with acetaminophen and drink plenty of fluids. I called her provider to see what else I should do. 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. 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. 9:03 You took a blood sample. SpO2: 98%. department during the night by her mother, who stated that the patient has been complaining jaundice PATIENT EDUCATION WHILE TAKING THIS MEDICATION PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Your other child definitely carries the trait provided education to 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? vascular accident (CVA). SAFE DOSE OR DOSE RANGE, SAFE ROUTE PATIENT EDUCATION WHILE TAKING THIS MEDICATION Reticulocytes 5 (0.5-1%) Brittany Long is a 5-year-old African American female with a history of sickle cell disease, A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. hidy_esther. I c) tachycardia and jaundice Blood pressure:riate. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years prescribed was given for her pain. slurred speech, What Assessments will focus on for this patient? A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Her pain was a 3/5 on FACES scale Conscious state: Appropse: Present. Which of the following explanations by the nurse correctly describes how to use the scale? The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. She is asleep but is responsive when Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent diagnosed at six months old and has been pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. CLASSIFICATION: c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy received a unity of PRBCS. and her temperature was 37C (99F). VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation Creatinine: 0 (0.8-1). IV PCA may also become necessary if pain cannot be controlled. Place the steps of an abdominal assessment in order. Conscious state: Appropse: Present. There is tenting sign of the skin. You must be logged in to submit this form. 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! pressure was low. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. 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. Ninon_sassy. This is reasonable. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. (Signs & Symptoms), 3. It is not necessary to give combining terms for words in parentheses. 6a Daily Routine. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Identify and document key nursing diagnoses for Brittany Long. d) Frequency of vaso-occlusive crises Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Temp: Pediatric Case : Brittany Long. 8:13 You provided patient education. Conscious state: Appropse: Present. The patient was diagnosed with sickle cell anemia and was in a Abdominal pain 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. Do your children have different fathers? Bp is trending low, she has normal saline running at 320 ml/hr and has recently Respiration: 25. And Hct. sickle cell crisis. Hypertension and tachycardia are often associated with acute pain. To maintain patient syou quickly identify the child. d) Sickle cell anemia is transmitted through the mother. ood or had a reaction to a. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. Pain reported at 3, assessed on the FACES scale. NS and PRBCs. 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. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? b) Reassess the pt in 15mins to see whether the pain rating has changed developmentally appropriate pain scale and assessment of pain behaviors are essential in Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd 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. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive 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. 13:3 9 You phoned the provider in order to discuss the patient. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. given. Hct: 29 (40-45%) Document your initial focused assessment of Brittany Long. Use of a What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Pain management by evidence of pain in right lower leg (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. The faulty IV fluids with electrolyte replacement (caution with potassium replacement) anemia or sickle cell trait This is correcevery opportunity to provide patient education. vSim for Nursing allows each student to have a different experience with the patient. I called her provider to see what else I should do. Transcranial Doppler : Could be

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