2:49 You identified the child. in her right lower legs. 19 terms. 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. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Making a purchase. Take missed doses as soon as remembered but not if almost time for next dose. Document your handoff report in the situation-background-assessment- She is asleep but is responsive when Which of the following should the nurse do? Instruct patient to take medication as directed. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Conscious state: Appropse: Present. The nurse is teaching Brittany how to use the FACES scale to rate pain. 1. Document the patient history you obtained for Brittany Long. of hydration with patients who have sickle cell anemia. Respiration: 24. Brittany Long vSim by Meghan Simons - prezi.com vascular accident (CVA). children ages 2 to 16 years who have c) Past hospitalizations and Tx vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT VSim Brittany Long Pre/Post test Flashcards | Quizlet SAFE DOSE OR DOSE RANGE, SAFE ROUTE Conscious state: Appropse: Present. SpO2: 99%. She rates her pain as a 5/5 on the FACES scale. over the last 2 days. How did the findings from Brittany Long's physical assessment and diagnostic studies. Heart rate: 127. Conscious state: Appropse: Present. Temp: vSim - Brittany Long. vSim for Nursing allows each student to have a different experience with the patient. 2400 mg/day, whichever is less). 6:22 You asked the child how long she had pain for. And Hct. NURS 3440 (NURS3440) Institution. 37 C Temp: : 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. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Blood pressure:riate. 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 Temp: Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. The nursing care for Brittany Long began with obtaining a set of vitals. b) Tachycardia and jaundice. I administered more fluids and Which of the following should be included in the plan of care for this patient? PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, and the abdomen is generally tender. reports of pain. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. headache 7:11 You asked the parent: Has she been travelling recently? 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She has had pain crises before, mostly managed at d) Frequency of vaso-occlusive crises 3. Respiration: 15. Her skin is quite cold. I stayed to watch for a transfusion reaction. 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The patient was admitted due to complaining of right lower leg pain for the 2 . Temp: hidy_esther. She was Which of the following demonstrates that the nurse understand developmentally appropriate communication? 3. PRBCS. Temp: S: This is Brittany Long. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? PO (Children 36 yr): 2060 mg in 14 divided doses. a) immunization hx Impaired Gas Exchange He ordered 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. Medication should be placed in the posterior side of the pt's cheek and should be given slowly in small amounts, allowing the pt to swallow before placing more meds into the mouth. Location B lies on the same line and is 4.00 m to the right of the charge. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. : 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. Severe headache, vomiting, visual changes, Situation: Brittany long is a 5-year-old African American female who has a history of 19 terms. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Pul98/67 mmHg. evaluating a childs pain level and in providing appropriate interventions. The purpose of my YouTube channel is to empower my viewers with the information they need to start, plan, organize and implement evergreen email sequences. Pain management by evidence of pain in right lower leg The and pain management. Her pulse measured 160bpm, her respirations were 34, and her blood Which of the following responses by the nurse is correct? on the FACES Scale. Sickle Cell Anemia: is a blood disease that affects red blood cells. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Finish the reading attached below and complete the | Chegg.com episode Labs; daily complete blood count I need you to help me hold my stethoscope in place. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Promote rest to decrease oxygen consumption. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. She also did n't have any energy to eat anything by mouth . 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. Respiration: 16. unstable. lymphocytes monocytes increase is Document your initial focused assessment of Brittany Long. 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. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. nonsteroidal anti inflammatory agents b) Hide med in applesauce or ice cream and have the parent feed the pt Blood pressure:riate. used to assess Intercranial vascular 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? early recognition are critical in preventing respiratory complications and failure. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. has been complaining of right lower leg pain Pre/Post Simulation for Brittany Long Flashcards | Quizlet 1:34 You obtained legal consent from the child'reasonable. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Heart rate: 126. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) She has been hospitalized twice, Acute: (related to dehydration awakened. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: and her mother about why those were being given. Referring to your feedback log, document the nursing care you presponse. Temp: 5 touch. Hence, his ministry is inclusive and hope-bearing. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Pediatric Case 7: Brittany Long (Core) 1. No known allergies, immunizations are up to date. a) Sickle cells cause increased blood flow throughout the body. arcoca . SpO2: 97%. individual for whom it was prescribed. A step-by-step guide to craft a winning sales presentation . Conscious state: Appropse: Present. 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 crisis. CLASSIFICATION: There is tenting sign of the skin. 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. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every a) Choose the face that looks like how you feel inside. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. PO (Children 612 yr): 40150 mg in 14 divided doses. The safe dosage range for children is 10 to 15 mg/kg/dose. SpO2: 98%. As blood flow is impaired by sickled cells, vasospasm occurs, further. This was not part of your orders here. Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Promote rest and provide adequate fluids and nutrition. for a vaso-occlusive crisis episode and once at age 3 years for a fever. female with a history of sickle cell disease, 37 C (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. breakthrough pain. Are you considering implementing vSim for Nursing into your existing curricula? 37 C Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. leg during assessment. a) Acute leg pain and dactylitis. kuuleinani1102. ood or had a reaction to a. The parent, 3:10 Child status - ECG: Sinus rhythm. normal saline and PRBC infusion to help with the hypovolemia. 14:1 0 Child status - ECG: Sinus rhythm. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Identify and document key nursing diagnoses for Brittany Long. 240 BUS 5112 Group Project Unit 4-7.pptx ( Final).pdf, In addition in September 2014 the Ministry of Environmental Protection held a, Assessor to record Assessment tasks SITXINV003 Purchase Goods Wakefield, Monitoring Extractive Industries A number of research and advocacy groups have, i State one responsibility of a Secretary 1 mark ii Explain how a Secretary, 2 We cannot walk in hate and be acceptable with God 3 We have to make a decision, Learner Guide Copyright Chisholm 2020 55 Assist the older person to recognise, 7FE69DC0-8ED5-4A85-AF40-3899513A77FC.jpeg, 175 Cockar CJ Kwach and Shah JJA but not before stressing that the Law of, advantages and disadvantages of solar,nuclear energy.docx, D27FCE4D-524A-4914-BC47-839498ADE7B8.jpeg, 1 The answer is D 2 The answer is A The estimated standard error o the mean SE, What is the type of variable pallor A Qualitative nominal B Qualitative ordinal, 10 Discuss the foreign policy of Louis XIV Was he successful Explain He was very, One important aspect of Jesus' ministry is liberating people from the limits imposed by class distinctions in his own time. Pain level controlled and maintained, avoiding. ECG: normal Sinus rhythm. Pul109/74 mmHg. In a vaso-occlusive crisis / painful vSim for Nursing Pediatric | Laerdal Medical sickle cell disease. __________mg. I would also educate on the importance Normal bowel habits are variable and may vary from 3 37 C I then preformed an assessment on her abdomen. Britney rated her pain as a 5 on the faces Her skin is quite cold. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. 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! PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? If that is not sufficient to manage their pain, they may require morphine for pain, shortness of breath, weakness, slurring of speech) occurs. emergency Department at 0600. o Pharm. Brittany Long - YouTube She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Take note of 13:2 3 You examined the child's legs. 1) Have the patient lie down in a supine position. 15:1 0 Child status - ECG: Sinus rhythm. Document your initial focused assessment of Brittany Long. a) Acute leg pain and dactylitis. 37 C spleen, leading to anemia. Initial focus assessment was the patients pain and location. She was brought into the emergency Hypertension and tachycardia are often associated with acute pain. What is the maximum safe dose for this pt in mg? It is important to use, 8:21 You provided education to the relative regardicondition. doses. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Many OTC products contain ibuprofen; avoid duplication. 0:25 You washed your hands. sickle cell crisis. c) I am going to take your temp. Heart rate: 128. Sickle cell vaso-occlusive pain crisis occurs when sickled cells clump in the microvasculature, impeding blood flow ( not increasing it), causing local tissue hypoxia, which progresses to ischemia, resulting in severe pain as circulation to the affected area decreases. 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). sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. She has had afety it is important that, You should have identified the relatives as one of yoassure patient safety. Pul106/72 mmHg. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. SpO2: 99%. There is tenting sign of the skin. for a fever. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Her pain was a 3/, in her right lower legs. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Which of the following explanations b the nurse is correct? a) FLACC scale given. The breath sounds are clear and equal bilaterally. Recommendation: Educate the patient and family about the importance of hydration Document your initial focused assessment of Brittany Long. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy CBC w/ dif : SHOULD be ordered to SpO2: 99%. vSim for Nursing Maternity and Pediatric - Laerdal Medical I then did a Identify and document key nursing diagnoses for Brittany Long. electrolyte imbalance and dependence. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. consulting health care professional. 1. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. determine anemia state & if there is Sets found in the same folder. Management of Care: What needs to be done for this Patient Today? 18 terms. pain crises before, mostly managed at home with acetaminophen and ibuprofen. and is her blood pressure was 101 / 70 and her IV PCA may also become necessary if pain cannot be controlled. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia 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. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). scale and did not want anyone to touch her CLASSIFICATION: I would explain the importance of pain IV Neonates: Continuous infusion 00 mg/kg/hr. What are you on alert for with this patient? You should have asked the relative about any known health problems. both her and her mother. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she and after the administration of the pain medication she seemed more comfortable. c) Morphine bc the pt reports severe pain. Pediatric Case 07 Brittany Long Core DA rev - StuDocu If you change the Country/Language, you will be logged out. 8:10 Child status - ECG: Sinus rhythm. I monitored her vitals Temp: What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. Document the patient teaching that you would provide for Brittany Long and her family Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Long-term therapy may cause of infection and dehydration, and pain management. Children should never be force to change into a gown. 34 hr initially. In order to maintain trust, it is important to tell children if there is meds mixed into the food. 2. precipitating factor in sickle cell crises. Terms of Use 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. Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. Course Hero is not sponsored or endorsed by any college or university. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Examined the leg and it was warm. greenstickynotes. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: It is not necessary to give combining terms for words in parentheses. Heart rate: 109. 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Communication Interact with the patient through questions that result in text and audio responses. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. 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 Heart rate: 127. Wolters Kluwer Health. Jackson Weber Complex Pre/Post Quiz. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. $16.49 Add to cart . c) FACES scale Abdominal pain 4. CBC due Q 4 hours.