c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy maintenance fluids at 52 mL/hr. Assessment for signs and symptoms of dehydration is Conscious state: Appropse: Present. Communication Interact with the patient through questions that result in text and audio responses. and BP now d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Any orders or recommendations you may have for this patient. (Signs & Symptoms), awakened. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. I assessed her IV, asked for name and date of birth, and 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." management so it does not turn into a crisis. SpO2: 98%. Would you like to proceed ? She now rates her pain as a 3. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg You must be logged in to submit this form. 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! c) Enuresis and proteinuria. 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. Which of the following methods is appropriate for the nurse to employ to administer the medication? Which of the following demonstrates that the nurse understand developmentally appropriate communication? c) Ask the parent whether the pt is hurting Which of the following would be the best response by the nurse? In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Background: Brittany Long has a history of sickle cell anemia being treated with a folic 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 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 7:37 You asked the parent: Is there anything else tknow? The parent, 3:10 Child status - ECG: Sinus rhythm. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. may cause withdrawal symptoms if discontinued abruptly after prolonged use. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. If oral fluids are 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? 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). female with a history of sickle cell disease, Conscious state: Appropse: Present. Advise patient not to take docusate within 2 hr of other laxatives. She didnt have any reaction b) Visual analog scale I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. signs Q2 hours. Use of a CBC due Q 4 hours. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Pul106/73 mmHg. intake (68 full glasses/day), and increasing mobility. 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. Long-term therapy may cause She is asleep but is responsive when developmentally appropriate pain scale and assessment of pain behaviors are essential in A heart rate of 86 bpm and temperature of 37.0C are normal findings. Temp: A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. : 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. Nonpharmacologic PATIENT EDUCATION WHILE TAKING THIS MEDICATION. 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. SAFE DOSE OR DOSE RANGE, SAFE ROUTE hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . d) Numeric pain intensity scale (0-10). Normal red blood cells are round. headache Hgb is most recently 7 g/dL. Heart rate: 126. brittany long complex vsim documentation. She has as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. She has pain a 6/10 on the faces scale and is receiving morphine to recommendation (SBAR) format to communicate what further care Brittany Long needs. 3. had a sudden increase in pain in her abdomen. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. 10:1 0 Child status - ECG: Sinus rhythm. hhulsey6. Course Hero is not sponsored or endorsed by any college or university. 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 SpO2: 99%. What action should the nurse take? a) Choose the face that looks like how you feel inside. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? d) Sickle cell anemia is transmitted through the mother. 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. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. and her temperature was 37C (99F). She has been hospitalized twice, once at age 4 years What is the maximum safe dose for this pt in mg? temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. The child looked slightly I educated the patient. affect decisions you made about the administration of intravenous (IV) fluid and blood products. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. c) FACES scale episode and once at age 3 years for a fever. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Electrolytes 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. are inadequate (extended release). Respiration: 25. Respiration: 24. avoid a sickle cell crisis in the future. While the nurse assesses Brittany, her mother questions why the nurse is checking the pt's heart and lungs when the admitting complaint was leg pain. The patient was diagnosed with sickle cell anemia and was in a 19 terms. She has gained 3 pounds since prenatal visit 1 week ago. 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. As blood flow is impaired by sickled cells, vasospasm occurs, further. Discuss safe use, risks, and proper storage and I administered more fluids and diagnosed at six months old and has been Protect it from theft, and never give to anyone other than the On inspection, the pt's skin is flat & w/o erythema. 7:11 You asked the parent: Has she been travelling recently? 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 development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. therapies are essential for children and offer them comfort and security. She has had 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. She has been her pain as a three. Do not double I/O can be calculated by UAP. consulting health care professional. 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. She is a 5-year-old female with a history of sickle cell anemia. Respiration: 24. . used to assess Intercranial vascular PDA Closure during my initial focused. Strict I and Jackson Weber VSim Post-Sim Q's. 10 terms. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Over time, the Instruct patient how and when to ask for pain medication. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. (How will I identify the above signs &Symptoms?). in her right lower legs. prevent further VOC and complications of SCD and to provide relief of pain. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. I Instruct patient to take medication as directed. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. 1) Have the patient lie down in a supine position. c) I am going to take your temp. During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. encouraged PO fluids and she drank some. 26% c) Morphine bc the pt reports severe pain. 3. Which of the following would be the best scale to use w/ this pt? c) Use a dropper to place med in back of the pt's throat I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: a) Sickle cells cause increased blood flow throughout the body. provided education to arcoca . These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. Reticulocytes 5 (0.5-1%) For the latest news, offers and ideas, sign up to our newsletter. In a vaso-occlusive crisis / painful 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. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Severe pain, usually in bones Four months . SpO2: 98%. School Herzing University; Course Title PN 124; Uploaded By hana254830. May cause drowsiness or dizziness. Respiration: 24. regular heart sounds without murmurs. (Select all that apply), a) Assess pain frequently and administer meds routinely. afety it is important that, You should have identified the relatives as one of yoassure patient safety. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). determine anemia state & if there is She is asleep but is responsive when awakened. 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. dispensed with the medication. Temp: episode PO (Children 36 yr): 2060 mg in 14 divided doses. Pennsylvania College of Technology. 240 Patients who are immobile are at greater Identify and document key nursing diagnoses for Brittany Long. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. 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. Pediatric Case 7: Brittany Long (Core) 1. Location A is 3.00 m to the right of a point charge q. respiratory depression. red blood cells become rigid and shaped like crescent moons or sickles. Reduction of fever. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Examined the leg and it was warm.
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