S: This is Brittany Long. e) Precipitating events. Pain reported at 3, assessed on the FACES scale. Blood pressure:riate. 3. She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. brittany long vsim step by step. 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. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device 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 Pre/Post Simulation for Brittany Long Flashcards | Quizlet 26% The patient was diagnosed with sickle cell anemia and was in a Transcranial Doppler : Could be Her pulse measured 160bpm, her respirations were 34, and her blood Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. We're available through e-mail, live chat and Facebook. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. This is reasonable. 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. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. 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). CBC due Q 4 hours. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. 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. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. brittany long complex vsim documentation. $16.49 Add to cart . b) Anemia and hypotension 13 terms. in her right lower legs. Comforting this advisable. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. 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. Over time, the o Pharm. 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 PATIENT EDUCATION WHILE TAKING THIS MEDICATION 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. Pul106/73 mmHg. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. 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. 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. rovided and Brittany Longs, 0:00 You introduced yourself. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. I (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE 37 C Stabilizing fluid levels to assist in relieving pain. 13 terms. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. He ordered, normal saline and PRBC infusion to help with the hypovolemia. 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? The parent ; 7:32 You asked the parent: Is there anything else tknow? tired. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Continuous Pulse Oximetry: SpO2: 98%. The nurse is reviewing lab data on a pt with sickle cell anemia. : 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. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: anemia or sickle cell trait 37 C acid supplement taken daily. We have noticed you are logged in to ${country}. bacterial. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. individual for whom it was prescribed. o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). During my initial focused assessment of Brittany Long I found that her vital signs were The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Cross), 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. 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The pt is lying quietly in bed watching TV. Instruct patient how and when to ask for pain medication. SpO2: 99%. 2. Recent flashcard sets. SpO2: 98%. Respiration: 25. had a sudden increase in pain in her abdomen. 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. Course Hero is not sponsored or endorsed by any college or university. I then preformed an assessment on her abdomen. Location B lies on the same line and is 4.00 m to the right of the charge. New orders have been. Peds v Sim Brittany Long by Avery Barshay - Prezi What is the magnitude and sign of the charge? The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Respiration: 24. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia When obtaining a health hx, the nurse should include questions r/t which of the following? For the latest news, offers and ideas, sign up to our newsletter. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Pennsylvania College of Technology. Her pain was a 3/5 on FACES scale 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 . Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Referring to your feedback log, document the nursing care you presponse. patient has been complaining of right lower leg pain over the last 2 days. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, IV fluids with electrolyte replacement (caution with potassium replacement) The spleen is enlarged, and after the administration of the pain medication she seemed more comfortable. She was PRBCS. e) Precipitating events Hence, his ministry is inclusive and hope-bearing. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Patients who are immobile are at greater Maintain adequate fluid intake and monitor urine output. I need you to help me hold my stethoscope in place. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. I also started incorporating more strength training into my gym routine. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Heart rate: 109. 9:31 You gave the child a sip of juice. The 2:49 You identified the child. TCD is performed annually on 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, Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Brought into the ED by her mother last night. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Respiration: 24. and is I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. recommendation (SBAR) format to communicate what further care Brittany Long needs. PO Infants: 5 mg/kg/day in 14 divided doses. Conscious state: Appropse: Present. Respiration: 24. Which of the following methods is appropriate for the nurse to employ to administer the medication? every 34 hr, maximum: 15 mg/dose. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. a) Administer the prescribed analgesic as ordered by her mother, who stated that the patient Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? o Pharmacologic: opioid agonists Temp: Hgb is most recently 7 g/dL. Pul98/67 mmHg. blood and then administered it. If you change the Country/Language, you will be logged out. : 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. Examined the leg and it was warm. CBC w/ dif : SHOULD be ordered to of infection and dehydration, and pain management. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? a) immunization hx per hour period when examined this morning Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent VSim Brittany Long Pre/Post test. Document your initial focused assessment of Brittany Long. dispensed with the medication. hands and feet cool to touch. 1. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Caution patient to call for assistance when ambulating Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Hgb 9 (13.5-17) are inadequate (extended release). 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. Initial focus assessment was the patients pain and location. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Advise patient that morphine is a drug with known abuse potential. Blood pressure:te. PO (Children 612 yr): 40150 mg in 14 divided doses. abdomen is generally tender. Brittany Long Vsim/ Broward College - NUR 250LBrittanyLongVsim - Stuvia 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. her blood pressure was 101 / 70 and her Document your . Pediatric Case 07 Brittany Long Core DA rev, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. Instruct patient to take medication as directed. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. The faulty 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. 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. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. What are you on alert for with this patient? Diagnosed with sickle cell disease at age 6 months. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). NSAIDs. d) Anemia and hypotension. Do not double Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. 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, Infant, Child And Adolescent Nursing (NSG 441).
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