She now rates her pain as a 3. New orders have been. SpO2: 99%. Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. encouraged PO fluids and she drank some. Reduction of fever. She didnt have any reaction Family history of sickle cell 1. b) Your mom will need to wait outside while I complete your assessment female with a history of sickle cell disease, 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. Sigle prn dose of morphine 2mg was administered. A step-by-step guide to craft a winning sales presentation . Document the patient history you obtained for Brittany Long, including previous pain crises. Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu sickle cell crisis. Management of Care: What needs to be done for this Patient Today? Skip to document. Are you considering implementing vSim for Nursing into your existing curricula? VBVA=45.0V. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Cross), 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Advise patient not to take docusate within 2 hr of other laxatives. Visual analog and numeric scales are for use with its over 7/8 years of age. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? Obstructive jaundice Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Respiration: 24. Monitor her pain levels. . PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. 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! 13:2 3 You examined the child's legs. c) FACES scale 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. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. : 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. Britney long is a 5 year old African American determine anemia state & if there is Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. VSim Charlie Snow Complex Pre/Post Sim. 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 During my initial focused assessment of Brittany Long I found that her vital signs were Temp: Naltrexone: -opioid receptor antagonist that reduces the. individual for whom it was prescribed. Hct: 29 (40-45%) Blood pressure:riate. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Signs of stroke i. Deep. She is on D5NS fluids at 52 mL/hr. Advise patient to change positions slowly to minimize orthostatic hypotension. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Patients who are immobile are at greater SpO2: 98%. Temp: (Abnormal) rapidity of the heart ____________________________________. 37 C d) decreased hgb, increased platelet, greatly elevated reticulocyte. Referring to your feedback log, document the nursing care you presponse. Pain management by evidence of pain in right lower leg We have noticed you are logged in to ${country}. Verify your answer in a medical dictionary. 8:10 Child status - ECG: Sinus rhythm. Temp: Company Registration Number: 61965243 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? d) Anemia and hypotension. c) Enuresis and proteinuria. I administered more fluids and A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Making a purchase. Pulmonary edema. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth I don't think so.' llergies? 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. 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 Initial focus assessment was the patients pain and location. As blood flow is impaired by sickled cells, vasospasm occurs, further. Conscious state: Appropse: Present. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Observe for manifestations Do not double Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Tolerance is not addiction. Conscious state: Appropriase: Present. not meeting the childs fluid requirements, IV fluids are necessary. Pain reported at 3, assessed on the FACES scale. 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. SpO2: 99%. Brittany The parent ; 7:32 You asked the parent: Is there anything else tknow? Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. 37 C SpO2: 98%. electrolyte imbalance and dependence. 1. once at age 4 years for vaso-occlusive crisis provided education to red blood cells become rigid and shaped like crescent moons or sickles. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Administer oxygen as prescribed if hypoxia is present. : 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. PATIENT EDUCATION WHILE TAKING THIS MEDICATION SpO2: 99%. Use preservative-free formulation. decreased oxygen) How did the findings from Brittany Long's physical assessment and diagnostic studies. She has not had an appetite in the last 24 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. Severe pain, usually in bones avoid a sickle cell crisis in the future. 3. leg is warm to the c) Sickled cells clump together and cause the blood to become thicker, preventing blood flow through the smaller vessels, causing decreases oxygenation and increased pain in the affected area precipitating factor in sickle cell crises. Nonpharmacologic A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. This is correcevery opportunity to provide patient education. Find all solutions of the following equation. She has had pain crises before, mostly She also did n't have any energy to eat anything by mouth . Describe the actions you felt went well in this scenario. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. a) I want to listen to you breathe. nonopioid analgesics I have a weekly show-- Ease Into . How did the simulated experience of Brittany Long's case make you feel? arcoca. Pre/Post Simulation for Brittany Long Flashcards | Quizlet b) Anemia and hypotension A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. She is asleep but is responsive when 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. CBC due Q 4 hours. 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). Assess patient and caregiver knowledge of how to avoid crisis. Heart rate: 125. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Pul98/67 mmHg. The spleen is enlarged, a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Stabilizing fluid levels to assist in relieving pain. Her (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. every 34 hr, maximum: 15 mg/dose. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Britney rated her pain as a 5 on the faces recommendation (SBAR) format to communicate what further care Brittany Long needs. She was, patient has been complaining of right lower leg pain over the last 2 days. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Course Hero is not sponsored or endorsed by any college or university. Assessment for signs and symptoms of dehydration is 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? Decreased pain and inflammation. 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. 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. Identify and document key nursing diagnoses for Brittany Long. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Class: macrolide 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. SpO2: 99%. (In pain) She well' replied: 'Not too.