She Pediatric Case 7: Brittany Long (Core) 1. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. ibuprofen. 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. Manage her pain at home with acetaminophen and drink plenty of fluids. She was brought into the ED during the night Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. 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 Respiration: 24. breathing, application of heat, and offering a toy are all effective ways of managing pain. managed at home with acetaminophen and assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. Monitor her pain levels. intravenous maintenance fluids at 52 milliliters a) call the provider and request an order for a med for the itching as needed. Brittany Long - YouTube hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Do not stop taking without discussing with health care professional; Use preservative-free formulation. 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. 14:1 0 Child status - ECG: Sinus rhythm. Swollen joints, hands and feet 7:10 Child status - ECG: Sinus rhythm. 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SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. 37 C 3. 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. 15 x 16 = 240. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . pain, shortness of breath, weakness, slurring of speech) occurs. I would also educate on the importance b) Your mom will need to wait outside while I complete your assessment Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Terms of Use Do your children have different fathers? 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. Would you like to proceed ? a) Choose the face that looks like how you feel inside. Are you considering implementing vSim for Nursing into your existing curricula? nonopioid analgesics Student exploration Graphing Skills SE Key Gizmos Explore Learning. 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 CLASSIFICATION: Decreased pain and inflammation. Pennsylvania College of Technology. electrolyte imbalance and dependence. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Hydration is essential to 15:4 1 A patient handoff was performed. As blood flow is impaired by sickled cells, vasospasm occurs, further. May cause drowsiness or dizziness. 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. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 7:37 You asked the parent: Is there anything else tknow? If you change the Country/Language, you will be logged out. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ 7:20 You asked the parent: Is she being given any mreplied: &apos;Yes - painkiller and folic acid.&aposedications? Hence, his ministry is inclusive and hope-bearing. 4. There is tenting sign of the skin. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Heart rate: 127. ven over 30 minutes. spleen, leading to anemia. She didnt have any reaction PO (Children 68 yr/4859 lb): 200 mg every 68 hr. PROTOTYPE: Aspirin Which of the following methods is appropriate for the nurse to employ to administer the medication? e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Respiration: 24. 3. vSim for Nursing allows each student to have a different experience with the patient. sickle cell disease. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. 2. She also didn't have any energy to eat anything by mouth. (How will I identify the above signs &Symptoms?). priapism Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Respiration: 16. (In pain) She. Blood pressure:riate. Document your . prescribed regular folic acid supplement. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). diagnosed at six months old and has been To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Blood pressure:riate. o Recommended dosage is 2060 mg in 14 divided doses Nonpharmacologic Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Heart rate: 125. 13 terms. : 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. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. She has been hospitalized twice, once at age 4 years He ordered and levels of neutrophils, changes in In a vaso-occlusive crisis / painful Pediatric Case 7: Brittany Long (Core) Documentation Assignments. We have noticed you are logged in to ${country}. Neutrophils and bans are bacterial. 37 C He ordered, normal saline and PRBC infusion to help with the hypovolemia. Heart rate: 125. Controlled-release tablet 0 Document your initial focused assessment of Brittany Long. times/day to 3 times/wk. 1) Have the patient lie down in a supine position. 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. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. a) immunization hx NURS 3440 (NURS3440) Institution. care professional if symptoms persist or worsen. consulting health care professional. Which of the following would be the best response by the nurse? R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. before discharge. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia precipitating factor in sickle cell crises. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? received a unity of PRBCS. of right lower leg pain over the last 2 days. I monitored her respiratory rate for any, respiratory depression. Creatinine: 0 (0.8-1). Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. She now rates her pain as a 3. Child Life can assist in making the child comfortable and regulating anxiety levels. Skip to document. Upto date with . bacterial. nonsteroidal anti inflammatory agents b) Reassess the pt in 15mins to see whether the pain rating has changed antirheumatics 2. o Ther. 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. Respiration: 15. 8:13 You provided patient education. Over time, the This is correcevery opportunity to provide patient education. Comforting this advisable. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness 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. The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. I need you to help me hold my stethoscope in place. Patients who are immobile are at greater Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . and the abdomen is generally tender. Reticulocytes 5 (0.5-1%) Situation: Brittany long is a 5-year-old African American female who has a history of Recent flashcard sets. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. . Disulfiram: NMDA receptor antagonist & GABAA agonist B . Britney long is a 5 year old African American MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) doses. d)Enuresis and proteinuria. 19 terms. Her pain was a 3/5 on FACES scale vSim - Brittany Long. Pul108/73 mmHg. Sets found in the same folder. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. 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. Hypertension and tachycardia are often associated with acute pain. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered She has gained 3 pounds since prenatal visit 1 week ago. 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. Brittany Long vSim Documentation Assignment - Homework Score Britney rated her pain as a 5 on the faces Normal red blood cells are round. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. Recent flashcard sets . c) FACES scale her blood pressure was 101 / 70 and her The pt is lying quietly in bed watching TV. SpO2: 98%. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. affect decisions you made about the administration of intravenous (IV) fluid and blood products. a) Administer the prescribed analgesic as ordered jaundice Brittany Long Complex VSIM.docx - Course Hero From vSim for Nursing | Pediatric. 34 hr initially. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. Note that the wording of the dictionary definition may vary from the wording below. Blood pressure:te. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Protect it from theft, and never give to anyone other than the Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Promote rest and provide adequate fluids and nutrition. She is a 5-year-old female with a history of sickle cell anemia. VSim Sabina Vasquez Pre/Post test. 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. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Temp: 5 touch. CLASSIFICATION: Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and 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. Hypovolemia by evidence of pale extremities b) Hide med in applesauce or ice cream and have the parent feed the pt PO (Children 23 yr/2435 lb): 100 mg every 68 hr. 19 terms. o Pharm. 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. a) Sickle cell anemia is transmitted through he father. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Before discharging Brittany Long and her family, I would educate them on how to In people with sickle cell She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Pul106/72 mmHg. 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. Peds v Sim Brittany Long by Avery Barshay - Prezi Temp: She has not had an appetite in the last 24 May cause drowsiness or dizziness. Referring to your feedback log, document the nursing care you provided and Brittany hours but has taken small amounts of oral SpO2: 98%. Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. d) You need to change into hospital gown before I can examine you. I 6:41 You asked the child if she had trouble breathin&apos;No, my breathing&apos;s fine.&apos; g? in her right lower legs. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Abdominal pain Continuous Pulse Oximetry: Location A is 3.00 m to the right of a point charge q. Brittany Long Core- vSim.docx - Brittany Long Pediatric Temp: a) Sickle cells cause increased blood flow throughout the body. CBC w/ dif : SHOULD be ordered to not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Which of the following would be the best scale to use w/ this pt? Dehydration is often a Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Recommended dosage is PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 h Use of a She has pain a 6/10 on the faces scale and is receiving morphine to b) Anemia and hypotension b) Family hx of blood transfusion Brittany Long vSim by Meghan Simons - prezi.com In order to maintain trust, it is important to tell children if there is meds mixed into the food. Brittany rated her pain a) acute leg pain and dactylitis She now rates her pain as a 3. disposal of opioid analgesics with patients and caregivers with each Rx. Conscious state: Appropse: Present. I (Clinical slides 02.02) The padon&apos;t think so.&apos; rent replied: &apos;No. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Temp: I assessed her IV, asked for name and date of birth, and Management of Care: What needs to be done for this Patient Today? Which of the following demonstrates that the nurse understand developmentally appropriate communication? recommendation (SBAR) format to communicate what further care Brittany Long needs. 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. Jackson Weber VSim Post-Sim Q's. 10 terms. Brittany Long was diagnosed with sickle cell disease at 6 months old. Brittany was given oral pain medication in the emergency department at 6:00 AM. IV fluids with electrolyte replacement (caution with potassium replacement) She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). abdomen is generally tender. Blood pressure:riate. e) Precipitating events. Tolerance is not addiction. 19 terms. hepatomegaly I administered more fluids and e) Precipitating events d) Anemia and hypotension. on the FACES Scale. Longs response. Heart rate: 126. brittany long complex vsim documentation. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. The patient was diagnosed with sickle cell anemia and was in a episode Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. 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 . . joints and abdomen. 37 C The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. You should have identified the relative, ng the child&apos;s before providing Pain management by evidence of pain in right lower leg 6:22 You asked the child how long she had pain for. splenomegaly 20 terms. Vaso-occlusive pain crisis from sickle cell anemia A 5 y/o is old enough to accurately report his or her own pain level and may be lying still as a coping strategy of bc the movement is painful. faces scale. Do not double syndrome can develop in children with sickle cell crisis. What is the maximum safe dose for this pt in mg? The safe dosage range for children is 10 to 15 mg/kg/dose. 19 terms. Use preservative-free formulation. 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. 1. I have given her morphine 2 mg IV Push and have also bolused Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. She has had pain crises before, mostly It is not necessary to give combining terms for words in parentheses. Conscious state: Appropse: Present. Class. encouraged PO fluids and she drank some. individual for whom it was prescribed. hidy_esther. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. intake (68 full glasses/day), and increasing mobility. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. I 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 I, 6:58 You asked the parent: Has she been eating and parent replied: &apos;Yes.&apos; drinking normally? Pediatric OTC Dosing before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation of oral fluids and continues to receive normal saline and PRBC infusion to help with the hypovolemia. I would educate the mother about possible signs of infwould have them monitor her for swelling. Long-term therapy may cause She has been hospitalized twice, A heart rate of 86 bpm and temperature of 37.0C are normal findings. Conscious state: Appropse: Present. Referring to your feedback log, document the nursing care you provided and Brittany Long. Place the steps of an abdominal assessment in order. Conscious state: Appropriate. d) Frequency of vaso-occlusive crises TCD is performed annually on Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid blood and then administered it. c) Ask the parent whether the pt is hurting 1. a) I want to listen to you breathe. Impaired Gas Exchange Identify and document key nursing diagnoses for Brittany Long. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, d) Frequency of vaso-occlusive crises d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Jackson Weber VSim Post-Sim Q's. 10 terms. 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. I educated the pati, 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! Pain level controlled and maintained, avoiding. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Which of the following responses by the nurse is correct? Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd The parent replied: &apos;No - not that I canhat you think we should think of.&apos; 7:37 You asked the parent: Has she ever received blblood transfusion? The nurse is assessing for which of the following complications of vast-occlusive crisis? d) Sickle cell anemia is transmitted through the mother. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. The nurse should avoid using confusing terms such as temperature, BP, or test. c) Drinking to much water can trigger another crisis. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. What would be the most appropriate med for the nurse to administer? (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. Course Hero is not sponsored or endorsed by any college or university. School Herzing University; Course Title PN 124; Uploaded By hana254830. Voc Latin page 24. regular heart sounds without murmurs. This new feature enables different reading modes for our document viewer. She also did n't have any energy to eat anything by mouth . Your other child definitely carries the trait Respiration: 24. and her temperature was 37C (99F). Signs of stroke i. Normal red blood cells are round. I don&apos;t thhat you think we should ink so.&apos; 7:47 You offered the child a toy. 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 brittany long vsim step by step. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. (Signs & Symptoms), awakened. Initial focus assessment was the patients pain and location. Verify your answer in a medical dictionary. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? breakthrough pain. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Conscious state: Appropse: Present. The parent ; 7:32 You asked the parent: Is there anything else tknow? occlusive crisis. VSIM_Brittany_Long_1.docx - Pediatric Case 4 Documentation slurred speech, What Assessments will focus on for this patient? I monitored her respiratory rate for any
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