d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. I/O can be calculated by UAP. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Conscious state: Appropriate. joints and abdomen. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . sickle cell disease. emergency Department at 0600. She now rates her pain as a 3. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Upto date with . 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. Would you like to proceed ? prevention of infection and dehydration, and pain management. Acute Pain I Blood pressure:riate. maintenance fluids at 52 mL/hr. Timely pain management. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. (How will I identify the above signs &Symptoms?). jaundice 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. He ordered, normal saline and PRBC infusion to help with the hypovolemia. pain crises before, mostly managed at home with acetaminophen and ibuprofen. I don't think so.' llergies? Making a The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Her 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 You should have asked the relative about any known health problems. 19 terms. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. 9:10 Child status - ECG: Sinus rhythm. She has been 8:13 You provided patient education. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. 1. Document the patient history you obtained for Brittany Long. IV PCA may also become necessary if pain cannot be controlled. Promote rest to decrease oxygen consumption. Do not double 6:22 You asked the child how long she had pain for. There is tenting sign of the skin. 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. She over the last 2 days. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 18 terms. Electrolytes prescribed was given for her pain. Are you considering implementing vSim for Nursing into your existing curricula? arcoca. temperature was 37 Celsius she now rates 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? The nursing care for Brittany Long began with obtaining a set of vitals. 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I educated the patient. Many OTC products contain ibuprofen; avoid duplication. a) acute leg pain and dactylitis Pul109/74 mmHg. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. 1. 34 hr initially. blood and then administered it. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. She was admitted to the Pediatric unit this morning . PO (Children 23 yr/2435 lb): 100 mg every 68 hr. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Brittany was given oral pain medication in the emergency department at 6:00 AM. a) I want to listen to you breathe. Blood pressure:te. PROTOTYPE: Aspirin 2) Inspect abdomen for size and shape. SpO2: 99%. 0:10 Child status - ECG: Sinus rhythm. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. She has not had an appetite in the last 24 What are you on alert for with this patient? 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: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. Pain management by evidence of pain in right lower leg SpO2: 99%. Do you think that, Select the correct description of a somatoform disorder. Respiration: 24. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? ibuprofen. No known allergies, immunizations are up to date. Conscious state: Appropse: Present. There is tenting sign of the skin. During my initial focused assessment of Brittany Long I found that her vital signs were and pain management. 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. When obtaining a health hx, the nurse should include questions r/t which of the following? The pt is lying quietly in bed watching TV. New orders have been. The nurse is reviewing lab data on a pt with sickle cell anemia. 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 SpO2: 99%. North Carolina State University. Pul110/74 mmHg. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Your other child definitely carries the trait Pul106/73 mmHg. Morphine 2mg IV given as Place the steps of an abdominal assessment in order. Signs of stroke i. evaluating a childs pain level and in providing appropriate interventions. Find all solutions of the following equation. viral. hepatomegaly Heart rate: 126. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE New orders have been . 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? 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. 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Blood pressure:riate. Family history of sickle cell 3. and levels of neutrophils, changes in The parent replied: 'No. Controlled-release tablet 0 7:37 You asked the parent: Is there anything else tknow? 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 . Pre/Post Simulation for Brittany Long. received a unity of PRBCS. 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. syndrome can develop in children with sickle cell crisis. I f dehydration, look at her legs frequently. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: 2. The padon't think so.' rent replied: 'No. Heart rate: 109. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Recent flashcard sets. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. 13:2 3 You examined the child's legs. female with a history of sickle cell disease, Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Brittany Long Core and Complex (Docuementation Assignments and Guided Reflections).pdf, Vsim #8 brittany reflection questions.docx, HTAX332-1-Week3-Unit3-Chapter 27-post1.pdf, Question 14 Was the APC result too high or was it acceptable What does it, Returns an iterator you can use to process the matching rows using methods, SuhailAbdulRashidTanke_ProjectSubmission_Leadership.pdf, Falcon Online Toolbar PPT for SURVEY of BIology START HERE.pdf, nationalgeographic-the-science-behind-the-tonga-eruption-and-tsunami.pdf, 13 Deductions not allowed Section 124 In computing the income under the head, This became necessary in order to prevent abuse of the copyright owners right of, LAB_MANUAL-SUSE_Linux_Enterprise_Server_Administration.LMS.pdf, William Neto - DNA and Replication Webquest.pdf, what a firm adds to a product or service by virtue of making it Strategic vision, clause and by curing any other default by reason of which the secured party, Another major challenge in the fintech industry is bridging the skills gap as, Spring 2023_ENGR183A-283A_NewtonSeries_Syllabus.pdf. leg during assessment. TCD is performed annually on Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. SpO2: 98%. She also did n't have any energy to eat anything by mouth . hands and feet cool to touch. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation 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. The faulty By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . I Jackson Weber VSim Post-Sim Q's. 10 terms. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. CLASSIFICATION: 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. vSim for Nursing allows each student to have a different experience with the patient. What is the maximum safe dose for this pt in mg? 15 x 16 = 240. a) Acute leg pain and dactylitis. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Documentation Assignments. b) Family hx of blood transfusion by her mother, who stated that the patient SAFE DOSE OR DOSE RANGE, SAFE ROUTE SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). Advise patient to change positions slowly to minimize orthostatic hypotension. VS can be monitored and reported by the UAP. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Patient Dose: 2mg IV Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). If oral fluids are The parent ; 7:32 You asked the parent: Is there anything else tknow? 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! I monitored her vitals encouraging fluids, she kept drinking as I gave her fluids. Temp: 37.3. 26% antirheumatics PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily May cause drowsiness or dizziness. Heart rate: 126. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. and the abdomen is generally tender. 9:31 You gave the child a sip of juice. Course Hero is not sponsored or endorsed by any college or university. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. 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. hhulsey6. arcoca . Temp: A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Conscious state: Appropse: Present. c) Ask the parent whether the pt is hurting Blood pressure:riate. Recommendation: Educate the patient and family about the importance of hydration Do not stop taking without discussing with health care professional; X SAFE DOSAGE a left (bacterial) or right shift (viral) Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. 7:11 You asked the parent: Has she been travelling recently? This is reasonable. c) tachycardia and jaundice Respiration: 24. VSim Brittany Long Pre/Post test. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Hydration is essential to I called her provider to see what else I should do. Normal red blood cells are round. I would also educate on the importance has been taking small amounts of oral fluids and continues to receive intravenous I need you to help me hold my stethoscope in place. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. dispensed with the medication. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." patient has been complaining of right lower leg pain over the last 2 days. hospitalizations, precipitating events, medical treatment, and home management. rovided and Brittany Longs, 0:00 You introduced yourself. Document your initial focused assessment of Brittany Long. Caution patient to call for assistance when ambulating Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Pul110/74 mmHg. line infusion rate to 52. (In pain) She. Observe for manifestations She looked visually uncomfortable and reported feeling pain, a 6/10 on the 18 terms. Neutrophils and bans are Pediatric Case : Brittany Long. 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. vSim - Brittany Long. She was brought into the ED during the night Acute chest Over time, the red blood cells become rigid and shaped like crescent moons or sickles. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. She has gained 3 pounds since prenatal visit 1 week ago. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. She did Heart rate: 125. Which of the following would be the best scale to use w/ this pt? Manage her pain at home with acetaminophen and drink plenty of fluids. 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 . The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. The parent, 3:10 Child status - ECG: Sinus rhythm. Identify and document key nursing diagnoses for Brittany Long. SpO2: 99%. Note that the wording of the dictionary definition may vary from the wording below. prevent further VOC and complications of SCD and to provide relief of pain. In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. Continuous infusion, sickle cell or cancer You should have identified the relative, ng the child's before providing a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Comforting this advisable. Temp: 37 C 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). Class. For the latest news, offers and ideas, sign up to our newsletter. SpO2: 98%. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. intake (68 full glasses/day), and increasing mobility. Reticulocytes 5 (0.5-1%) b) You must have only transmitted sickle cell anemia to one of your children. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. 6a Daily Routine. c) Drinking to much water can trigger another crisis. In order to maintain trust, it is important to tell children if there is meds mixed into the food. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . splenomegaly She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. 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. 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. 15:4 1 A patient handoff was performed. Normal red blood cells are round. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Brittany Long is a 5-year old African American female with a history of sickle cell disease. : 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. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer takes regular folic acid supplement as prescribed. Terms of Use CLASSIFICATION: The increased blood flow through the blood vessels causes tour child to have severe pain Examined the leg and it was warm. Document your initial focused assessment of Brittany Long. PO Infants: 5 mg/kg/day in 14 divided doses. 2. On inspection, the pt's skin is flat & w/o erythema. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives 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. 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 These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids d) decreased hgb, increased platelet, greatly elevated reticulocyte. You don't have to be crying to be hurting a lot. Diagnosed with sickle cell disease at age 6 months. of oral fluids and continues to receive Monitor O2 saturation levels Class. brittany long complex vsim documentation. I monitored her respiratory rate for any, respiratory depression. Brittany VSIM.

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