Pre/Post Simulation for Brittany Long. Heart rate: 128. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. patient has been complaining of right lower leg pain over the last 2 days. received a unity of PRBCS. home with acetaminophen and ibuprofen. The. hours but has taken small amounts of oral and is unstable. a) immunization hx 6a Daily Routine. Deep. Fluid and Electrolyte levels stabilized and maintained. (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). The nurse is performing a physical assessment on a 5 y/o pt. Four months . sickle cell crisis. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Pul97/66 mmHg. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Keep What would be the most appropriate med for the nurse to administer? He ordered, normal saline and PRBC infusion to help with the hypovolemia. 37 C PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Wolters Kluwer Health. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. provided education to Controlled-release tablet 0 vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. Bp is trending low, she has normal saline running at 320 ml/hr and has recently d)Enuresis and proteinuria. Conscious state: Appropse: Present. 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. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). She now rates her pain as a 3. Creatinine: 0 (0.8-1). ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. 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. This is reasonable. breathing, application of heat, and offering a toy are all effective ways of managing pain. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Blood pressure:riate. individual for whom it was prescribed. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. 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. 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. Manage her pain at home with acetaminophen and drink plenty of fluids. 13 terms. 1. Blood pressure:riate. Assess patient and caregiver knowledge of how to avoid crisis. VSim Brittany Long Pre/Post test. scale and did not want anyone to touch her SpO2: 99%. Upto date with . Obstructive jaundice Do not stop taking without discussing with health care professional; Document the patient history you obtained for Brittany Long, including previous pain crises. 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. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Educate patient and family on nutritional and fluid needs. takes regular folic acid supplement as prescribed. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Sets found in the same folder. She is asleep but is responsive when awakened. The right lowertouch. Heart rate: 109. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. slurred speech, What Assessments will focus on for this patient? leg is warm to the 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. nonsteroidal anti inflammatory agents pressure was low. NS and PRBCs. 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 . . Assessment for signs and symptoms of dehydration is mg Brittany Long was diagnosed with sickle cell disease at 6 months old. When examined this morning, her blood pressure was 101/ 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. I do about 40 minutes of it five times a week. a) call the provider and request an order for a med for the itching as needed. c) Morphine bc the pt reports severe pain. Temp: 5 touch. She has had Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). 6:22 You asked the child how long she had pain for. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. 0 mg/kg every 12 hr. Neutrophils and bans are The potential difference between the two locations is. 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. c) I am going to take your temp. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. b) Your mom will need to wait outside while I complete your assessment 15:1 0 Child status - ECG: Sinus rhythm. Document your . Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. lymphocytes monocytes increase is The parent replied: 'No. leg during assessment. I stayed to watch for a transfusion reaction. Do your children have different fathers? o Pharmacologic: opioid agonists Note that the wording of the dictionary definition may vary from the wording below. Tolerance is not addiction. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). line infusion rate to 52. The spleen is enlarged, splenomegaly ood or had a reaction to a. 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! Document the patient teaching that you would provide for Brittany Long and her family You don't have to be crying to be hurting a lot. reports of pain. 1) Have the patient lie down in a supine position. Antipyretic 5 mg/kg for PATIENT EDUCATION WHILE TAKING THIS MEDICATION dispensed with the medication. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. 37 C 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. b) Tachycardia and jaundice. She rates her pain as a 5/5 on the FACES scale. Referring to your feedback log, document the nursing care you provided and Brittany shortness of breath, fatigue A step-by-step guide to craft a winning sales presentation . 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. Which of the following explanations b the nurse is correct? are inadequate (extended release). d) Frequency of vaso-occlusive crises 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? b) Family hx of blood transfusion What action should the nurse take? Respiration: 15. Conscious state: Appropse: Present. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without maintenance fluids at 52 mL/hr. acid supplement taken daily. 37 C a) acute leg pain and dactylitis Monitoring oxygenation, use of incentive spirometry, hydration, and The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. To maintain patient syou quickly identify the child. Heart rate: 127. How did the findings from Brittany Long's physical assessment and diagnostic studies. Brittany rated her pain temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. Brittany o Recommended dosage is 2060 mg in 14 divided doses Conscious state: Appropse: Present. 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. Hypertension and tachycardia are often associated with acute pain. The safe dosage range for children is 10 to 15 mg/kg/dose. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Pul109/74 mmHg. care professional if symptoms persist or worsen. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. pain, shortness of breath, weakness, slurring of speech) occurs. Before discharging Brittany Long and her family, I would educate them on how to Signs of stroke i. Initial focus assessment was the patients pain and location. 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. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Conscious state: Appropriate. atelectasis. She has early recognition are critical in preventing respiratory complications and failure. and levels of neutrophils, changes in c) Ask the parent whether the pt is hurting X SAFE DOSAGE critical, particularly in young children, whose fluid stores are rapidly depleted. If you change the Country/Language, you will be logged out. You must be logged in to submit this form. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Conscious state: Appropse: Present. not meeting the childs fluid requirements, IV fluids are necessary. Document your initial focused assessment of Brittany Long. Transcranial Doppler : Could be vSim - Brittany Long. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. PO (Children 612 yr): 40150 mg in 14 divided doses. Abdominal pain Pediatric Case : Brittany Long. encouraged PO fluids and she drank some. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: Blood pressure:riate. temperature was 37 Celsius she now rates Acute chest pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Her pulse measured 160bpm, her respirations were 34, and her blood 18 terms. IV fluids with electrolyte replacement (caution with potassium replacement) by her mother, who stated that the patient Administer oxygen as prescribed if hypoxia is present. (Signs & Symptoms), awakened. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Respiration: 24. Respiration: 24. Fanny373. Your other child definitely carries the trait poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Hematuria TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Identify and document key nursing diagnoses for Brittany Long. determine anemia state & if there is PO (Children 36 yr): 2060 mg in 14 divided doses. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? s relative. treat it. Verify your answer in a medical dictionary. She has had pain crises before, mostly managed at She also didn't have any energy to eat anything by mouth. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. hhulsey6. Strict I and Examined the leg and it was warm. Pulmonary edema. Pediatric Case 7: Brittany Long (Core) 1. bacterial. Store out of sight and reach of children, and in a location not accessible by others. SpO2: 98%. before discharge. Severe headache, vomiting, visual changes, Child Life can assist in making the child comfortable and regulating anxiety levels. If that is not sufficient to manage their pain, they may require morphine for pain assessment and asked her if she would like any medication for her pain. He ordered (In pain) She well' replied: 'Not too. TCD is performed annually on 26% Sickle Cell Anemia: is a blood disease that affects red blood cells. Normal bowel habits are variable and may vary from 3 37 C Course Hero is not sponsored or endorsed by any college or university. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Initial focus assessment was the patients pain and location. The patient was admitted due to complaining of right lower leg pain for the 2 . As blood flow is impaired by sickled cells, vasospasm occurs, further. 7:11 You asked the parent: Has she been travelling recently? doses. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. encouraging fluids, she kept drinking as I gave her fluids. 1:34 You obtained legal consent from the child'reasonable. b) Anemia and hypotension Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? CLASSIFICATION: Making a What are you on alert for with this patient? a) I want to listen to you breathe. Making a purchase. 7:37 You asked the parent: Is there anything else tknow? Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Severe pain, usually in bones Nonpharmacologic Temp: signs Q2 hours. 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 1 CHE101 - Summary Chemistry: The Central Science, Ethan Haas - Podcasts and Oral Histories Homework, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, PSY HW#3 - Homework on habituation, secure and insecure attachment and the stage theory, Lesson 17 Types of Lava and the Features They Form, 1010 - Summary Worlds Together Worlds Apart, Lessons from Antiquity Activities US Government, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, SCS 200 Applied Social Sciences Module 1 Short Answers, Greek god program by alex eubank pdf free, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Lab 3 Measurement Measuring Volume SE (Auto Recovered), Ati-rn-comprehensive-predictor-retake-2019-100-correct-ati-rn-comprehensive-predictor-retake-1 ATI RN COMPREHENSIVE PREDICTOR RETAKE 2019_100% Correct | ATI RN COMPREHENSIVE PREDICTOR RETAKE, 1-2 Module One Activity Project topic exploration, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, 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, Nursing Care of the Childbearing Family (NURS 125), Closely observe for manifestations of crisis and infection. arcoca. 3. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. b) Hide med in applesauce or ice cream and have the parent feed the pt 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). And Hct. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Acute Pain 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 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. The parent, 3:10 Child status - ECG: Sinus rhythm. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. 2. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Do not double Are you considering implementing vSim for Nursing into your existing curricula? Her skin is quite cold. Patient C/C right lower leg pain over the last 2 days. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. viral. I need you to help me hold my stethoscope in place. Company Registration Number: 61965243 once at age 4 years for vaso-occlusive crisis 2400 mg/day, whichever is less). a. Xist Communication Interact with the patient through questions that result in text and audio responses. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). SpO2: 99%. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. blood and then administered it. her pain as a three. 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. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 13:3 9 You phoned the provider in order to discuss the patient. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Heart rate: 126. e) Precipitating events. Pul110/74 mmHg. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 15:4 1 A patient handoff was performed. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. 20 terms. vascular accident (CVA). Her pain was a 3/5 on FACES scale a) Sickle cells cause increased blood flow throughout the body. o Therapeutic: opioid analgesics c) FACES scale syndrome can develop in children with sickle cell crisis. prevent further VOC and complications of SCD and to provide relief of pain. A heart rate of 86 bpm and temperature of 37.0C are normal findings. pain 02 mg/kg/hr. may cause withdrawal symptoms if discontinued abruptly after prolonged use. She was brought into the emergency Pain management by evidence of pain in right lower leg d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. antirheumatics In a vaso-occlusive crisis / painful Place the steps of an abdominal assessment in order. Documentation Assignments. 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