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. and is Jackson Weber VSim Post-Sim Q's. 10 terms. From vSim for Nursing | Pediatric. Which of the following explanations b the nurse is correct? 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. She has pain a 6/10 on the faces scale and is receiving morphine to Referring to your feedback log, document the nursing care you provided and Brittany Pain reported at 3, assessed on the FACES scale. breakthrough pain. Over time, the 8:10 Child status - ECG: Sinus rhythm. Jackson Weber VSim Post-Sim Q's. 10 terms. 3. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). c) I am going to take your temp. ood or had a reaction to a. 1. Conscious state: Appropriase: Present. The right lowertouch. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, Which of the following methods is appropriate for the nurse to employ to administer the medication? flow and detect the risk for cerebral antipyretics and pain management. vSim - Brittany Long. a) Choose the face that looks like how you feel inside. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. awakened. Document your initial focused assessment of Brittany Long. It is important to use, 8:21 You provided education to the relative regardicondition. nonsteroidal anti inflammatory agents 0:25 You washed your hands. Blood pressure:te. Document your . VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. (How will I identify the above signs &Symptoms?). Assessment for signs and symptoms of dehydration is Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. She has gained 3 pounds since prenatal visit 1 week ago. 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. Conscious state: Appropse: Present. CBC due Q 4 hours. What are you on alert for with this patient? Blood pressure:riate. 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! a left (bacterial) or right shift (viral) NURS 3440 (NURS3440) Institution. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: X SAFE DOSAGE in her right lower legs. 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 . Situation: Brittany long is a 5-year-old African American female who has a history of Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. The nursing care for Brittany Long began with obtaining a set of vitals. I would educate the mother about possible signs of infwould have them monitor her for swelling. 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? 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. 37 C The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Pre/Post Simulation for Brittany Long. Respiration: 24. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, pressure was low. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. The nurse is teaching Brittany how to use the FACES scale to rate pain. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered 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. Brittany VSIM. The patient was diagnosed with sickle cell anemia and was in a 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, New orders have been. Pul110/74 mmHg. d) Frequency of vaso-occlusive crises electrolyte imbalance and dependence. 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. 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 Ineffective Tissue Perfusion Background: Brittany Long has a history of sickle cell anemia being treated with a folic I need you to help me hold my stethoscope in place. consulting health care professional. dizziness PO (Children 612 yr): 40150 mg in 14 divided doses. 6a Daily Routine. 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? Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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. I stayed to watch for a transfusion reaction. Her pain was a 3/, in her right lower legs. and levels of neutrophils, changes in The nurse should avoid using confusing terms such as temperature, BP, or test. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Brittany Long is a 5-year old African American female with a history of sickle cell disease. greenstickynotes. 13:2 3 You examined the child's legs. Normal bowel habits are variable and may vary from 3 The nurse is reviewing lab data on a pt with sickle cell anemia. Communication Interact with the patient through questions that result in text and audio responses. Deep. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . a) Acute leg pain and dactylitis. Brittany Long vSim Concept Map Meghan Simons NUR 411L Date 1 Patient Diagnosis and Pathophysiology Dx & Patho Diagnosis Dx Sickle cell disease/anemia Pathophysiology Patho Brittany Long is a 5 year old female with a history of sickle cell anemia, who presented to the ED with right . Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 1) Have the patient lie down in a supine position. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. She has been hospitalized twice, once at age 4 years black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest PURPOSE FOR TAKING THIS MEDICATION, Treatment of: fluids. VBVA=45.0V. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. 2. Britney was given oral pain medication in the She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Use preservative-free formulation. Temp: 37.3. o Pharm. Decreased pain and inflammation. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. 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. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy over the last 2 days. Document your initial focused assessment of Brittany Long. Pul110/74 mmHg. She didnt have any reaction 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. regular heart sounds without murmurs. Naltrexone: -opioid receptor antagonist that reduces the. It is not necessary to give combining terms for words in parentheses. (Signs & Symptoms), 3. a. Xist Which of the following demonstrates that the nurse understand developmentally appropriate communication? Respiration: 25. Pulse: Present. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). a) immunization hx Place the steps of an abdominal assessment in order. Respiration: 24. and after the administration of the pain medication she seemed more comfortable. Making a purchase. 3. Her She also didn't have any energy to eat anything by mouth. once at age 4 years for vaso-occlusive crisis Document the patient history you obtained for Brittany Long, including previous pain crises. . Use preservative-free formulation. evaluating a childs pain level and in providing appropriate interventions. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Blood pressure:riate. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. for a fever. (Signs & Symptoms), awakened. 18 terms. Describe the actions you felt went well in this scenario. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Sigle prn dose of morphine 2mg was administered. The breath sounds are clear and equal bilaterally. VS can be monitored and reported by the UAP. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? d) decreased hgb, increased platelet, greatly elevated reticulocyte. headache She is a 5-year-old female with a history of sickle cell anemia. encouraging fluids, she kept drinking as I gave her fluids. I then did a Conscious state: Appropse: Present. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. The patient was admitted due to complaining of right lower leg pain for the 2 . Document your initial focused assessment of Brittany Long. signs Q2 hours. She did Circulating sickle cells are hemolysized by the. jaundice Heart rate: 128. Identify and document key nursing diagnoses for Brittany Long. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I VSim Sabina Vasquez Pre/Post test. and her mother about why those were being given. times/day to 3 times/wk. VSim Charlie Snow Complex Pre/Post Sim. c) FACES scale a) I want to listen to you breathe. Fluid and Electrolyte levels stabilized and maintained. arcoca . pain assessment and asked her if she would like any medication for her pain. SpO2: 98%. atelectasis. This was part of your order. 15:1 0 Child status - ECG: Sinus rhythm. d) Anemia and hypotension. IF you have four children, one or 25% will have sickle cell anemia. 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. IV fluids with electrolyte replacement (caution with potassium replacement) Conscious state: Appropriase: Present. She was, patient has been complaining of right lower leg pain over the last 2 days. Heart rate: 127. Temp: 5 touch. o Recommended dosage is 2060 mg in 14 divided doses Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Comforting this advisable. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. 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). 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. normal saline and PRBC infusion to help with the hypovolemia. 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, Care of the childrearing family (nurs420). Conscious state: Appropse: Present. 1. 3. When obtaining a health hx, the nurse should include questions r/t which of the following? d) You need to change into hospital gown before I can examine you. c) Ask the parent whether the pt is hurting . PATIENT EDUCATION WHILE TAKING THIS MEDICATION Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). When examined this morning, her blood pressure was 101/ (Clinical slides 02.02) d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. CLASSIFICATION: Initial focus assessment was the patients pain and location. 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). Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I worked my way up to an hour of cardio per workout session. 37 C For the latest news, offers and ideas, sign up to our newsletter. 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! If you change the Country/Language, you will be logged out. Monitoring oxygenation, use of incentive spirometry, hydration, and Recent flashcard sets . Acute: (related to dehydration 0 mg/kg every 12 hr. Location B lies on the same line and is 4.00 m to the right of the charge. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Visual disturbances. Respiration: 24. Conscious state: Appropse: Present. Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . Upto date with . 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. Long-term therapy may cause PROTOTYPE: Aspirin splenomegaly Her skin is quite cold. 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. She now rates her pain as a 3. 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! b) Reassess the pt in 15mins to see whether the pain rating has changed She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. How did the simulated experience of Brittany Long's case make you feel? Morphine 2mg IV. 4. Conscious state: Appropse: Present. Brittany VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. Instruct patient to take medication as directed. She is asleep but is responsive when awakened. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. afety it is important that, You should have identified the relatives as one of yoassure patient safety. CLASSIFICATION: What is the magnitude and sign of the charge? 20 terms. The padon't think so.' rent replied: 'No. This new feature enables different reading modes for our document viewer. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." management so it does not turn into a crisis. Pediatric OTC Dosing I monitored her respiratory rate for any, respiratory depression. Respiration: 24. b) Anemia and hypotension She has been Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . before discharge. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). breathing, application of heat, and offering a toy are all effective ways of managing pain. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids (Clinical slides 02.02.2020), It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS).