o Pharmacologic: opioid agonists VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia for a fever. 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. Course Hero is not sponsored or endorsed by any college or university. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. a) acute leg pain and dactylitis a) FLACC scale : 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. c) Past hospitalizations and Tx d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Pul110/74 mmHg. b) Visual analog scale The parent, 3:10 Child status - ECG: Sinus rhythm. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Documentation Assignments. 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. 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. Location A is 3.00 m to the right of a point charge q. Advise patient that morphine is a drug with known abuse potential. 37 C Pediatric Case 08 Brittany Long Complex DA - StuDocu SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years To maintain patient syou quickly identify the child. has been complaining of right lower leg pain Vital played with and became more comfortable with. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Morphine 2mg IV given as Monitor O2 saturation levels You must be logged in to submit this form. Reduction of fever. The nurse is teaching Brittany how to use the FACES scale to rate pain. both her and her mother. Monitoring oxygenation, use of incentive spirometry, hydration, and Respiration: 24. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. NS and PRBCs. Hematuria The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Examined the leg and it was warm. Ineffective Tissue Perfusion PATIENT EDUCATION WHILE TAKING THIS MEDICATION unstable. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Document your initial focused assessment of Brittany Long. Respiration: 24. 6a Daily Routine. Heart rate: 109. brought into the emergency department during the night by her mother, who stated that the Temp: School Herzing University; Course Title PN 124; Uploaded By hana254830. episode and once at age 3 years for a fever. You should have asked the relative about any known health problems. Would you like to proceed ? kuuleinani1102. PATIENT EDUCATION WHILE TAKING THIS MEDICATION vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. 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. faces scale. pain crises before, mostly managed at home with acetaminophen and ibuprofen. Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. I need you to help me hold my stethoscope in place. Pul110/74 mmHg. 15:1 0 Child status - ECG: Sinus rhythm. vSim for Nursing Maternity and Pediatric - Laerdal Medical prescribed was given for her pain. Find all solutions of the following equation. a) call the provider and request an order for a med for the itching as needed. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Hypovolemia by evidence of pale extremities Initial focus assessment was the patients pain and location. 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? assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. a) Sickle cells cause increased blood flow throughout the body. flow and detect the risk for cerebral It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: Monitor and note changes in level of consciousness, reports of headache, dizziness, When obtaining a health hx, the nurse should include questions r/t which of the following? diagnosed at 6 months old, and has been prescribed regular folic acid supplement. New orders have been 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. Discuss safe use, risks, and proper storage and Promote rest and provide adequate fluids and nutrition. I would explain the importance of pain In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. SpO2: 98%. (Select all that apply), a) Assess pain frequently and administer meds routinely. : 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. acid supplement taken daily. Respiration: 24. Blood pressure:riate. shortness of breath, fatigue The parent replied: 'No. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." PRBCS. d) Numeric pain intensity scale (0-10). Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. breakthrough pain. She now rates her pain as a 3. 2. Company Registration Number: 61965243 and levels of neutrophils, changes in Advise patient not to take docusate within 2 hr of other laxatives. What is the maximum safe dose for this pt in mg? 3. Caution patient to call for assistance when ambulating Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Administer oxygen as prescribed if hypoxia is present. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Respiration: 25. arcoca. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). She now rates her pain as a 3. Transcranial Doppler : Could be 37 C Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). 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. Dehydration is often a She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. nonopioid analgesics 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. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. o Ther. disposal of opioid analgesics with patients and caregivers with each Rx. Promote rest to decrease oxygen consumption. Diagnosed with sickle cell disease at age 6 months. 10:1 0 Child status - ECG: Sinus rhythm. 13:3 9 You phoned the provider in order to discuss the patient. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. 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. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. and her temperature was 37C (99F). 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. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . jaundice The nurse is performing a physical assessment on a 5 y/o pt. Creatinine: 0 (0.8-1). And Hct. 26% Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. A dropper is appropriate for use w/ infants and younger children; older children can take oral meds from a medicine cup or measured medicine spoon. b) Family hx of blood transfusion A step-by-step guide to craft a winning sales presentation . PATIENT EDUCATION WHILE TAKING THIS MEDICATION. She was brought into the emergency I then preformed an assessment on her abdomen. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. What would be the most appropriate med for the nurse to administer? Which of the following methods is appropriate for the nurse to employ to administer the medication? We're available through e-mail, live chat and Facebook. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. PDA Closure She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Heart rate: 128. 37 C Hct: 29 (40-45%) children ages 2 to 16 years who have Pul106/73 mmHg. I called her provider to see what else I should do. Pul110/74 mmHg. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. 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. Background: Brittany Long has a history of sickle cell anemia being treated with a folic mg Brittany Long was diagnosed with sickle cell disease at 6 months old. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? : an American History (Eric Foner), Unfolding Clinical Reasoning Case Study Mandy Gray, NUR203 SR Clinical #2 - VSIM #3 information, United States History, 1550 - 1877 (HIST 117), Human Anatomy And Physiology I (BIOL 2031), Strategic Human Resource Management (OL600), Concepts of Medical Surgical Nursing (NUR 170), Expanding Family and Community (Nurs 306), Basic News Writing Skills 8/23-10/11Fnl10/13 (COMM 160), American Politics and US Constitution (C963), Professional Application in Service Learning I (LDR-461), Advanced Anatomy & Physiology for Health Professions (NUR 4904), Principles Of Environmental Science (ENV 100), Operating Systems 2 (proctored course) (CS 3307), Comparative Programming Languages (CS 4402), Business Core Capstone: An Integrated Application (D083), 315-HW6 sol - fall 2015 homework 6 solutions, 3.4.1.7 Lab - Research a Hardware Upgrade, BIO 140 - Cellular Respiration Case Study, Civ Pro Flowcharts - Civil Procedure Flow Charts, Test Bank Varcarolis Essentials of Psychiatric Mental Health Nursing 3e 2017, Historia de la literatura (linea del tiempo), Is sammy alive - in class assignment worth points, Sawyer Delong - Sawyer Delong - Copy of Triple Beam SE, Conversation Concept Lab Transcript Shadow Health, 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. Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu A step-by-step guide to craft a winning sales presentation . Peds v Sim Brittany Long by Avery Barshay - Prezi a) acute leg pain and dactylitis sickle cell crisis. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. Fanny373. Do your children have different fathers? Course Hero is not sponsored or endorsed by any college or university. Identify and document key nursing diagnoses for Brittany Long. Visual disturbances. not meeting the childs fluid requirements, IV fluids are necessary. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Conscious state: Appropriase: Present. c) Past hospitalizations and Tx Pul109/74 mmHg. 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. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Manage her pain at home with acetaminophen and drink plenty of fluids. consulting health care professional. b) Reassess the pt in 15mins to see whether the pain rating has changed She looked visually uncomfortable and reported feeling pain, a 6/10 on the Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." 14:1 0 Child status - ECG: Sinus rhythm. 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. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. lymphocytes monocytes increase is sickle cell disease. Brittany Long Complex VSIM.docx - Course Hero Decreased pain and inflammation. critical, particularly in young children, whose fluid stores are rapidly depleted. Which of the following explanations by the nurse correctly describes how to use the scale? IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or You should have identified the relative, ng the child's before providing pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. blood and then administered it. viral. antirheumatics Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Jackson Weber Complex Pre/Post Quiz. Neutrophils and bans are 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. dispensed with the medication. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. 6:22 You asked the child how long she had pain for. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ e) Precipitating events early recognition are critical in preventing respiratory complications and failure. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? Do not double 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. The parent replied: 'No - not that I canhat you think we should think of.' 7:37 You asked the parent: Has she ever received blblood transfusion? The patient was diagnosed with sickle cell anemia and was in a 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! She was before discharge. Brittany Long was diagnosed with sickle cell disease at 6 months old. SpO2: 98%. I educated the pati, Chemistry: The Central Science (Theodore E. 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