Respiration: 24. She has been taking small amounts ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Identify and document key nursing diagnoses for Brittany Long. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). 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. Blood pressure:te. Heart rate: 125. Normal red blood cells are round. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I referral to the pain team may also be helpful in SCD crises management. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Which of the following would be the best scale to use w/ this pt? I listened to her lungs (clear and equal bilaterally), checked h(99%), checked her pulse, attached the NIBP (110/74), took heer RR (24), attached the pulse ox r temp (37), did a pain Conscious state: Appropse: Present. a) immunization hx These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Document your initial focused assessment of Brittany Long. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. PO Infants: 5 mg/kg/day in 14 divided doses. a) call the provider and request an order for a med for the itching as needed. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every 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). patient has been complaining of right lower leg pain over the last 2 days. I educated the patient. 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, a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. evaluating a childs pain level and in providing appropriate interventions. brittany long vsim step by step. Four months . (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE both her and her mother. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. acid supplement taken daily. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . before discharge. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies, RR: 24 breaths/ min, chest is moving equally, Brachial pulse: 130bpm, strong and regular, Skin has normal elasticity, color is a bit pale and skin is cool, Pt reports pain is in her right lower leg, onset: a few days, Warm touch normal elasticity slightly pale skin is cool, No redness, swelling, infiltration, bleeding, or drainage, Asked patient if sheis feeling better for which she replied, Yesp, I feel better., a) Offer the pt a favorite stuffed toy and distract her by asking about the animal, b) Place a heating pad on the pt leg and have her mother read her a story, e) Encourage deep breathing by having the pt blow bubbles, *Management of sickle cell crisis is aimed at managing pain and promoting circulation. 3. 4. antipyretics During my initial focused assessment of Brittany Long I found that her vital signs were hands and feet cool to touch. She is on D5NS fluids at 52 mL/hr. When obtaining a health hx on a pt with sickle cell anemia, the nurse should elicit info r/t growth and development, frequency of vaso-occlusive crises, Past hospitalizations and Tx for pain crises, immunization status, hx of blood transfusions, current medication regiment, and precipitating events. determine anemia state & if there is PATIENT EDUCATION WHILE TAKING THIS MEDICATION c) Use a dropper to place med in back of the pt's throat b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. Hypovolemia by evidence of pale extremities Discuss safe use, risks, and proper storage and B: She came in with right lower leg pain, and that has since been stabilized, but she has Management of Care: What needs to be done for this Patient Today? She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. 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. 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. Promote rest to decrease oxygen consumption. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. 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! Continuous infusion, sickle cell or cancer I then preformed an assessment on her abdomen. female with a history of sickle cell disease, education. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily ood or had a reaction to a. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid 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. : an American History (Eric Foner), Unfolding Clinical Reasoning Case Study Mandy Gray, NUR203 SR Clinical #2 - VSIM #3 information, United States History, 1550 - 1877 (HIST 117), Human Anatomy And Physiology I (BIOL 2031), Strategic Human Resource Management (OL600), Concepts of Medical Surgical Nursing (NUR 170), Expanding Family and Community (Nurs 306), Basic News Writing Skills 8/23-10/11Fnl10/13 (COMM 160), American Politics and US Constitution (C963), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), 315-HW6 sol - fall 2015 homework 6 solutions, 3.4.1.7 Lab - Research a Hardware Upgrade, BIO 140 - Cellular Respiration Case Study, Civ Pro Flowcharts - Civil Procedure Flow Charts, Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017, Historia de la literatura (linea del tiempo), Is sammy alive - in class assignment worth points, Sawyer Delong - Sawyer Delong - Copy of Triple Beam SE, Conversation Concept Lab Transcript Shadow Health, 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. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Decreased pain and inflammation. In the ED Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. She was brought into the emergency M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Document your . She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. Document your initial focused assessment of Brittany Long. How did the simulated experience of Brittany Long's case make you feel? respiratory depression. She has been SpO2: 99%. The potential difference between the two locations is. a) Sickle cells cause increased blood flow throughout the body. 1. Company Registration Number: 61965243 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. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Conscious state: Appropse: Present. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Look for signs oection such as fever and shortness of breath. . atelectasis. arcoca . home with acetaminophen and ibuprofen. rovided and Brittany Longs, 0:00 You introduced yourself. and her temperature was 37C (99F). a left (bacterial) or right shift (viral) decreased oxygen) Use preservative-free formulation. Pul110/74 mmHg. Blood pressure:riate. Sigle prn dose of morphine 2mg was administered. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered antirheumatics 37 C d)Enuresis and proteinuria. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. 7:37 You asked the parent: Is there anything else tknow? and educated the mother about signs of a reaction. Conscious state: Appropse: Present. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. She Educate patient and family on nutritional and fluid needs. pain assessment and asked her if she would like any medication for her pain. episode Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Conscious state: Appropse: Present. Location B lies on the same line and is 4.00 m to the right of the charge. What is the magnitude and sign of the charge? Hematuria 1. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Acute chest a) acute leg pain and dactylitis Pain reported at 3, assessed on the FACES scale. 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? Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Creatinine: 0 (0.8-1). brittany long complex vsim documentation. PO (Children 36 yr): 2060 mg in 14 divided doses. 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. In people with sickle cell Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. 37 C, 6:13 You asked the child if anything made the pain breplied: &apos;No&apos; etter. 1:34 You obtained legal consent from the child&apos;reasonable. Conscious state: Appropriate. Find all solutions of the following equation. b) Your mom will need to wait outside while I complete your assessment This new feature enables different reading modes for our document viewer. Normal red blood cells are round. once at age 4 years for vaso-occlusive crisis Respiration: 25. Temp: Patient Dose: 2mg IV Examined the leg and it was warm. Pennsylvania College of Technology. vSim - Brittany Long. Visual disturbances. Jackson Weber VSim Post-Sim Q's. 10 terms. regular heart sounds without murmurs. greenstickynotes. a) Acute leg pain and dactylitis. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. 14:1 0 Child status - ECG: Sinus rhythm. Advise patient that morphine is a drug with known abuse potential. avoid a sickle cell crisis in the future. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer He ordered PO (Children 11 yr/7295 lb): 300 mg every 68 hr. department during the night by her mother, who stated that the patient has been complaining Do your children have different fathers? c) Past hospitalizations and Tx To maintain patient syou quickly identify the child. Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . Use preservative-free formulation. The. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Fanny373. 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. Her skin is quite cold. emergency Department at 0600. You should have identified the relative, ng the child&apos;s before providing jaundice proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ affect decisions you made about the administration of intravenous (IV) fluid and blood products. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without splenomegaly Temp: What are you on alert for with this patient? She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, Her pain was a 3/5 on FACES scale Upto date with . 3. Identify and document key nursing diagnoses for Brittany Long. a) Sickle cell anemia is transmitted through he father. of right lower leg pain over the last 2 days. Signs of stroke i. 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. 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 a) Choose the face that looks like how you feel inside. a) Administer the prescribed analgesic as ordered electrolyte imbalance and dependence.