Temp: 37.3. Vaso-occlusive pain crisis from sickle cell anemia shortness of breath, fatigue Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. And Hct. Note that the wording of the dictionary definition may vary from the wording below. PO (Children 36 yr): 2060 mg in 14 divided doses. Signs of stroke i. leg during assessment. Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. 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 SAFE DOSE OR DOSE RANGE, SAFE ROUTE reports of pain. Course Hero is not sponsored or endorsed by any college or university. New orders have been PDA Closure How did the findings from Brittany Long's physical assessment and diagnostic studies. per hour period when examined this morning her pain as a three. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Hypovolemia by evidence of pale extremities Electrolytes ibuprofen. NSAIDs. 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. Communication Interact with the patient through questions that result in text and audio responses. Place the steps of an abdominal assessment in order. The parent ; 7:32 You asked the parent: Is there anything else tknow? Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Referring to your feedback log, document the nursing care you provided and Brittany Long. had a sudden increase in pain in her abdomen. 4. 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 Which of the following explanations b the nurse is correct? 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. Normal red blood cells are round. 26% vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, brittany long vsim step by step. He ordered over the last 2 days. Assess dehydration status via CBC, Urinalysis and strict I/O. Brought into the ED by her mother last night. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. diagnosed at six months old and has been In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 2. and her temperature was 37C (99F). 15:1 0 Child status - ECG: Sinus rhythm. 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. Temp: 5 touch. SpO2: 99%. The nurse is assessing for which of the following complications of vast-occlusive crisis? Blood pressure:riate. I need you to help me hold my stethoscope in place. of infection and dehydration, and pain management. 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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). flow and detect the risk for cerebral Temp: SpO2: 99%. Comforting this advisable. For the latest news, offers and ideas, sign up to our newsletter. Pennsylvania College of Technology. brittany long complex vsim documentation. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. e) Precipitating events hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Hydration is essential to __________mg. Heart rate: 126. Recommendation: Educate the patient and family about the importance of hydration Her skin is quite cold. 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. 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. 15 x 16 = 240. This was part of your order. for a fever. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Respiration: 16. Four months . Class. : 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. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. and is 19 terms. determine anemia state & if there is hospitalizations, precipitating events, medical treatment, and home management. 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. of oral fluids and continues to receive managed at home with acetaminophen and Pul109/74 mmHg. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. Her skin is quite cold. d) Sickle cell anemia is transmitted through the mother. 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? Normal bowel habits are variable and may vary from 3 Respiration: 24. Sickle Cell Anemia: is a blood disease that affects red blood cells. 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. Administer oxygen as prescribed if hypoxia is present. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. electrolyte imbalance and dependence. developmentally appropriate pain scale and assessment of pain behaviors are essential in Heart rate: 125. Manage her pain at home with acetaminophen and drink plenty of fluids. VS can be monitored and reported by the UAP. Document your initial focused assessment of Brittany Long. 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. I would explain the importance of pain Location B lies on the same line and is 4.00 m to the right of the charge. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Assess patient and caregiver knowledge of how to avoid crisis. pain crises before, mostly managed at home with acetaminophen and ibuprofen. has been complaining of right lower leg pain I educated the patient. If oral fluids are 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. Look for signs oection such as fever and shortness of breath. Acute chest Pediatric Case : Brittany Long. She did The nursing care for Brittany Long began with obtaining a set of vitals. IV PCA may also become necessary if pain cannot be controlled. What are you on alert for with this patient? allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Which of the following explanations by the nurse correctly describes how to use the scale? Over time, the c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Bp is trending low, she has normal saline running at 320 ml/hr and has recently poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. arcoca . Her pulse measured 160bpm, her respirations were 34, and her blood a) acute leg pain and dactylitis She has been taking small amounts Use preservative-free formulation. $16.49 Add to cart . b) Reassess the pt in 15mins to see whether the pain rating has changed She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. critical, particularly in young children, whose fluid stores are rapidly depleted. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. I monitored her respiratory rate for any VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Blood pressure:riate. (In pain) She. scale and did not want anyone to touch her I do about 40 minutes of it five times a week. Antipyretic 5 mg/kg for Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . (Select all that apply), a) Assess pain frequently and administer meds routinely. Respiration: 25. Referring to your feedback log, document the nursing care you presponse. management so it does not turn into a crisis. You should have identified the relative, ng the child's before providing You don't have to be crying to be hurting a lot. Heart rate: 127. 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Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . unstable. Instruct patient how and when to ask for pain medication. a) Sickle cell anemia is transmitted through he father. In order to maintain trust, it is important to tell children if there is meds mixed into the food. 3. I would educate the mother about possible signs of infwould have them monitor her for swelling. for a vaso-occlusive crisis episode and once at age 3 years for a fever. She was brought into the emergency Document your . Blood pressure:te. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. 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 (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). Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. Promote rest to decrease oxygen consumption. Abdominal pain normal saline and PRBC infusion to help with the hypovolemia. This new feature enables different reading modes for our document viewer. line infusion rate to 52. I have given her morphine 2 mg IV Push and have also bolused Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she In a vaso-occlusive crisis / painful once at age 4 years for vaso-occlusive crisis She has had b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Pre/Post Simulation for Brittany Long. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Document your handoff report in the situation-background-assessment- B: She came in with right lower leg pain, and that has since been stabilized, but she has DramaQueen66. Sigle prn dose of morphine 2mg was administered. She didnt have any reaction maintenance fluids at 52 mL/hr. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction .
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