I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? CBC w/ dif : SHOULD be ordered to I administered more fluids and treat it. Temp: PO (Children 910 yr/6071 lb): 250 mg every 68 hr. b) Family hx of blood transfusion . Respiration: 24. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. 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! 10:1 0 Child status - ECG: Sinus rhythm. And Hct. PO (Children <3 yr): 1040 mg in 14 divided doses. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. d) decreased hgb, increased platelet, greatly elevated reticulocyte. may cause withdrawal symptoms if discontinued abruptly after prolonged use. Pediatric Case : Brittany Long. Pennsylvania College of Technology. home with acetaminophen and ibuprofen. 2. Advise patient to change positions slowly to minimize orthostatic hypotension. Location A is 3.00 m to the right of a point charge q. Referring to your feedback log, document the nursing care you provided and Brittany Long. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. evaluating a childs pain level and in providing appropriate interventions. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. regular heart sounds without murmurs. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. red blood cells become rigid and shaped like crescent moons or sickles. The. 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. a) Acute leg pain and dactylitis. Blood pressure:riate. pain 02 mg/kg/hr. The increased blood flow through the blood vessels causes tour child to have severe pain PATIENT EDUCATION WHILE TAKING THIS MEDICATION SpO2: 98%. Class: macrolide then assessed her IV and she seemed nervous, so I offered her a stuff dog who she Conscious state: Appropse: Present. has been taking small amounts of oral fluids and continues to receive intravenous 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? a) Administer the prescribed analgesic as ordered Find all solutions of the following equation. 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. Blood pressure:te. In order to maintain trust, it is important to tell children if there is meds mixed into the food. a) I want to listen to you breathe. 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. hours but has taken small amounts of oral 0 mg/kg every 12 hr. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 13:2 3 You examined the child's legs. She has gained 3 pounds since prenatal visit 1 week ago. VSim Sabina Vasquez Pre/Post test. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. She has been hospitalized twice, 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. a. Xist Recent flashcard sets . brittany long complex vsim documentation. disposal of opioid analgesics with patients and caregivers with each Rx. e) Precipitating events She has had pain crises before, mostly pallor, pale mucous membranes every 34 hr, maximum: 15 mg/dose. 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! a) Acute leg pain and dactylitis. 19 terms. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Dehydration is often a Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Company Registration Number: 61965243 SpO2: 99%. I have given her morphine 2 mg IV Push and have also bolused She is on D5NS fluids at 52 mL/hr. hhulsey6. PRBCS. Conscious state: Appropse: Present. 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 . She rates her pain as a 5/5 on the FACES scale. awakened. Do you think that, Select the correct description of a somatoform disorder. 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 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? 18 terms. b) Hide med in applesauce or ice cream and have the parent feed the pt Acute: (related to dehydration It is important to use, 8:21 You provided education to the relative regardicondition. Making a Referring to your feedback log, document the nursing care you presponse. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy decreased oxygen) Respiration: 24. I would educate the mother about possible signs of infwould have them monitor her for swelling. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. and is Blood pressure:riate. Respiration: 24. Examined the leg and it was warm. Conscious state: Appropse: Present. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. I stayed to watch for a transfusion reaction. Store out of sight and reach of children, and in a location not accessible by others. She has e) Precipitating events. normal saline and PRBC infusion to help with the hypovolemia. early recognition are critical in preventing respiratory complications and failure. The parent replied: 'No. Take note of Document your initial focused assessment of Brittany Long. Labs; daily complete blood count 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? PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Acute chest Pul106/72 mmHg. unstable. She has not had an appetite in the last 24 breathing, application of heat, and offering a toy are all effective ways of managing pain. I called her provider to see what else I should do. Course Hero is not sponsored or endorsed by any college or university. headache New orders have been 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, Conscious state: Appropse: Present. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: of hydration with patients who have sickle cell anemia. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. 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. d) Frequency of vaso-occlusive crises I would also educate on the importance Patients who are immobile are at greater This was, 2:10 Child status - ECG: Sinus rhythm. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. 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? emergency Department at 0600. Her pain was a 3/5 on FACES scale proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ A step-by-step guide to craft a winning sales presentation . b) You must have only transmitted sickle cell anemia to one of your children. 3. PROTOTYPE: Morphine. Nonpharmacologic Four months . a) immunization hx 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. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. She also didn't have any energy to eat anything by mouth. 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. Temp: Many OTC products contain ibuprofen; avoid duplication. 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 Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. 8:10 Child status - ECG: Sinus rhythm. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. 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. 7:11 You asked the parent: Has she been travelling recently? 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Pediatric Case 7: Brittany Long (Core) 1. c) Ask the parent whether the pt is hurting Document your initial focused assessment of Brittany Long. and pain management. 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. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Pul109/74 mmHg. Initial focus assessment was the patients pain and location. How did the simulated experience of Brittany Long's case make you feel? 1. Document your . She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. b) Visual analog scale Conscious state: Appropriase: Present. Student exploration Graphing Skills SE Key Gizmos Explore Learning. b) Anemia and hypotension Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. also on 2L nasal cannula. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). You must be logged in to submit this form. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. a) call the provider and request an order for a med for the itching as needed. Pulse: Present. 19 terms. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). nonopioid analgesics managed at home with acetaminophen and Heart rate: 127. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. NS and PRBCs. Heart rate: 126. Hypertension and tachycardia are often associated with acute pain. 9:10 Child status - ECG: Sinus rhythm. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. Temp: 37.3. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Blood pressure:riate. Sickled RBCs, become rigid and cresent shaped. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Her skin is quite cold. Temp: Britney rated her pain as a 5 on the faces Do your children have different fathers? Student exploration Graphing Skills SE Key Gizmos Explore Learning. No known allergies, immunizations are up to date. The nursing care for Brittany Long began with obtaining a set of vitals. Recommendation: Educate the patient and family about the importance of hydration 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. Continuous infusion, sickle cell or cancer SpO2: 98%. takes regular folic acid supplement as prescribed. You should have asked the relative about any known health problems. Vital 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. I then preformed an assessment on her abdomen. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Circulating sickle cells are hemolysized by the. Normal red blood cells are round. diagnosed at six months old and has been VS can be monitored and reported by the UAP. Look for signs oection such as fever and shortness of breath. Conscious state: Appropriate. during my initial focused. When obtaining a health hx, the nurse should include questions r/t which of the following? dizziness shortness of breath, fatigue V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. o Pharmacologic: opioid agonists flow and detect the risk for cerebral Acute Pain Protect it from theft, and never give to anyone other than the Initial focus assessment was the patients pain and location. (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? Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. given. maintenance fluids at 52 mL/hr. 4. c) I am going to take your temp. Advise patient not to take docusate within 2 hr of other laxatives. sickle cell disease. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Over time, the red blood cells become rigid and shaped like crescent moons or sickles. I also started incorporating more strength training into my gym routine. sickle cell crisis. vSim for Nursing: Pediatric Case 3: Eva Madis, NUR 307: VSim Sabina Vasquez Pre/Post test, Medical Condition in Pregnancy Part I HTN GDM, Fetal Assessment for Risk Factors (Exam 3), Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Upto date with . 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. episode developmentally appropriate pain scale and assessment of pain behaviors are essential in Communication Interact with the patient through questions that result in text and audio responses. Respiration: 24. What action should the nurse take? Use of a once at age 4 years for vaso-occlusive crisis Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Sets found in the same folder. 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. of right lower leg pain over the last 2 days. TCD is performed annually on 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. Severe pain, usually in bones 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. She has been hospitalized twice, once at age 4 years reports of pain. kuuleinani1102. Pul109/74 mmHg. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. 1:34 You obtained legal consent from the child'reasonable. vSim for Nursing allows each student to have a different experience with the patient. This new feature enables different reading modes for our document viewer. line infusion rate to 52. scale and did not want anyone to touch her She is asleep but is responsive when viral. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Conscious state: Appropse: Present. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr.