The. 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. $16.49 Add to cart . Examined the leg and it was warm. episode o Pharmacologic: opioid agonists She also didn't have any energy to eat anything by mouth. The breath sounds are clear and equal bilaterally. You should have asked the relative about any known health problems. a) Sickle cells cause increased blood flow throughout the body. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Wolters Kluwer Health. Temp: Respiration: 24. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. over the last 2 days. Pennsylvania College of Technology. I verified with two nurses in regard to the d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Advise patient to change positions slowly to minimize orthostatic hypotension. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. (How will I identify the above signs &Symptoms?). 240 __________mg. She was brought into the emergency This was not part of your orders here. Blood pressure:riate. We have noticed you are logged in to ${country}. Vaso-occlusive pain crisis from sickle cell anemia 2. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. Her skin is quite cold. Conscious state: Appropse: Present. d)Enuresis and proteinuria. Promote rest to decrease oxygen consumption. Instruct patient how and when to ask for pain medication. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. 6:22 You asked the child how long she had pain for. SAFE DOSE OR DOSE RANGE, SAFE ROUTE c) FACES scale Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Strict I and 1:34 You obtained legal consent from the child'reasonable. Blood pressure:riate. Circulating sickle cells are hemolysized by the. She is a 5-year-old female with a history of sickle cell anemia. sickle cell disease. Fanny373. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Student exploration Graphing Skills SE Key Gizmos Explore Learning. PROTOTYPE: Aspirin PROTOTYPE: Morphine. This was part of your order. The parent ; 7:32 You asked the parent: Is there anything else tknow? Her pain was a 3/5 on FACES scale Are you considering implementing vSim for Nursing into your existing curricula? The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). The increased blood flow through the blood vessels causes tour child to have severe pain 11:1 0 Child status - ECG: Sinus rhythm. Place the steps of an abdominal assessment in order. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. regular heart sounds without murmurs. NURS 3440 (NURS3440) Institution. syndrome can develop in children with sickle cell crisis. To maintain patient syou quickly identify the child. Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. home with acetaminophen and ibuprofen. hours but has taken small amounts of oral afety it is important that, You should have identified the relatives as one of yoassure patient safety. She has been taking small amounts temperature was 37 Celsius she now rates black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest She has Sickled RBCs, become rigid and cresent shaped. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids intravenous maintenance fluids at 52 milliliters The right lowertouch. prescribed regular folic acid supplement. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. (In pain) She well' replied: 'Not too. 19 terms. b) Reassess the pt in 15mins to see whether the pain rating has changed developmentally appropriate pain scale and assessment of pain behaviors are essential in b) Your mom will need to wait outside while I complete your assessment Pul108/73 mmHg. Pul106/73 mmHg. Patients who are immobile are at greater 34 hr initially. Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. I need you to help me hold my stethoscope in place. North Carolina State University. I don't think so.' llergies? If you change the Country/Language, you will be logged out. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. 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. a) Choose the face that looks like how you feel inside. If that is not sufficient to manage their pain, they may require morphine for Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Blood pressure:riate. used to assess Intercranial vascular Respiration: 16. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT Situation: Brittany long is a 5-year-old African American female who has a history of She is asleep but is responsive when awakened. Sickle Cell Anemia: is a blood disease that affects red blood cells. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent of hypervolemia and transfusion reaction. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. Hct: 29 (40-45%) 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 . 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 of right lower leg pain over the last 2 days. She was brought into the ED during the night In order to maintain trust, it is important to tell children if there is meds mixed into the food. intake (68 full glasses/day), and increasing mobility. The padon't think so.' rent replied: 'No. 20 terms. 3. As blood flow is impaired by sickled cells, vasospasm occurs, further. I would also educate on the importance and levels of neutrophils, changes in c) Past hospitalizations and Tx Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. I stayed to watch for a transfusion reaction. 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). Making a Assess dehydration status via CBC, Urinalysis and strict I/O. Children should never be force to change into a gown. 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? Do your children have different fathers? Temp: pain, shortness of breath, weakness, slurring of speech) occurs. I worked my way up to an hour of cardio per workout session. . 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). Assessment for signs and symptoms of dehydration is Administer oxygen as prescribed if hypoxia is present. a) Acute leg pain and dactylitis. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. She was admitted to the Pediatric unit this morning . Which of the following should be included in the plan of care for this patient? I Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health Respiration: 25. I monitored her respiratory rate for any, respiratory depression. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Keep Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer She has pain a 6/10 on the faces scale and is receiving morphine to 18 terms. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Ineffective Tissue Perfusion ven over 30 minutes. IV PCA may also become necessary if pain cannot be controlled. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Company Registration Number: 61965243 Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. c) I am going to take your temp. slurred speech, What Assessments will focus on for this patient? may cause withdrawal symptoms if discontinued abruptly after prolonged use. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Pediatric Case 07 Brittany Long Core DA rev - StuDocu reports of pain Continuous Pulse Oximetry: unstable. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. and educated the mother about signs of a reaction. 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Her skin is quite cold. a) I want to listen to you breathe. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. I/O can be calculated by UAP. Temp: Use preservative-free formulation. provided education to Respiration: 24. She also did n't have any energy to eat anything by mouth . Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex line infusion rate to 52. Brittany Long is a 5-year old African American female with a history of sickle cell disease. PATIENT EDUCATION WHILE TAKING THIS MEDICATION She was You don't have to be crying to be hurting a lot. occlusive crisis. (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). atelectasis. She has gained 3 pounds since prenatal visit 1 week ago. She is on D5NS fluids at 52 mL/hr. SpO2: 97%. When examined this morning, her blood pressure was 101/ VBVA=45.0V. 19 terms. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia 0:25 You washed your hands. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. vSim - Brittany Long Flashcards | Quizlet Brittany Long Complex VSIM.docx - Course Hero Finish the reading attached below and complete the | Chegg.com and her temperature was 37C (99F). Look for signs oection such as fever and shortness of breath. priapism Which of the following would be the best response by the nurse? Hence, his ministry is inclusive and hope-bearing. 37 C Class: macrolide SpO2: 98%. 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. children ages 2 to 16 years who have CLASSIFICATION: hands and feet cool to touch. 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! Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . 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. Making a purchase. faces scale. Respiration: 24. This is reasonable. greenstickynotes. Morphine 2mg IV. Pul98/67 mmHg. The nurse is teaching Brittany how to use the FACES scale to rate pain. Which of the following responses by the nurse is correct? 1. Advise patient not to take docusate within 2 hr of other laxatives. Temp: diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. individual for whom it was prescribed. I pressure was low. 2400 mg/day, whichever is less). 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. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Respiration: 24. leg during assessment. Initial focus assessment was the patients pain and location. red blood cells become rigid and shaped like crescent moons or sickles. Nonpharmacologic SpO2: 98%. electrolyte imbalance and dependence. A step-by-step guide to craft a winning sales presentation . I assessed her IV, asked for name and date of birth, and Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 37 C Store out of sight and reach of children, and in a location not accessible by others. before discharge. maintenance fluids at 52 mL/hr. 7:10 Child status - ECG: Sinus rhythm. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA).
