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Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Hypovolemia by evidence of pale extremities c) tachycardia and jaundice atelectasis. Recent flashcard sets . b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. : 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. 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 9:31 You gave the child a sip of juice. Ninon_sassy. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Upto date with . Note that the wording of the dictionary definition may vary from the wording below. The parent replied: &apos;No. Dehydration is often a Blood pressure:riate. and is Brought into the ED by her mother last night. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . (In pain) She well&apos; replied: &apos;Not too. 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. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. No known allergies, immunizations are up to date. 18 terms. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Acute: (related to dehydration Leadership and Management in Nursing (NUR 4773), Advanced Concepts in Applied Behavior Analysis (PSY7709), Intermediate Medical Surgical Nursing (NRSG 250), 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), Ch. Decreased pain and inflammation. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. CLASSIFICATION: Finish the reading attached below and complete the | Chegg.com Summary - Fatime sanogo vsim steps&period; fatime sanogo age&colon;&tab;23 years diagnosis&colon;&tab;induction . 14:1 0 Child status - ECG: Sinus rhythm. Respiration: 24. Brittany was given oral pain medication in the emergency department at 6:00 AM. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. (In pain) She replied: 6:49 You asked the parent: When the problems starte&apos;A few days ago.&apos; d. The parent replied: 6:54 You asked the parent: Has she had fever? brought into the emergency department during the night by her mother, who stated that the a) Acute leg pain and dactylitis. a) acute leg pain and dactylitis Naltrexone: -opioid receptor antagonist that reduces the. 37 C referral to the pain team may also be helpful in SCD crises management. Patient C/C right lower leg pain over the last 2 days. Conscious state: Appropse: Present. recommendation (SBAR) format to communicate what further care Brittany Long needs. 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? b) Anemia and hypotension (Clinical slides 02.02) Conscious state: Appropriase: Present. pressure was low. CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. She is asleep but is responsive when Advise patient to inform health care professional of medication regimen prior to treatment or surgery. 34 hr initially. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. VSim Sabina Vasquez Pre/Post test. 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. scale and did not want anyone to touch her Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Over time, the May cause drowsiness or dizziness. A step-by-step guide to craft a winning sales presentation . PROTOTYPE: Aspirin PROTOTYPE: Morphine. episode and once at age 3 years for a fever. Temp: Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. 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. c) Drinking to much water can trigger another crisis. faces scale. 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. VSim Brittany Long Pre/Post test Flashcards | Quizlet School Herzing University; Course Title PN 124; Uploaded By hana254830. She now rates her pain as a 3. Temp: VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . She did anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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? CLASSIFICATION: Patients who are immobile are at greater children ages 2 to 16 years who have encouraging fluids, she kept drinking as I gave her fluids. She is asleep but is responsive when awakened. given. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Circulating sickle cells are hemolysized by the. 6:41 You asked the child if she had trouble breathin&apos;No, my breathing&apos;s fine.&apos; g? 3. a) immunization hx If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) greenstickynotes. Visual disturbances. Recommendation: Educate the patient and family about the importance of hydration SpO2: 98%. She has How did the findings from Brittany Long's physical assessment and diagnostic studies. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. He ordered administer blood products, usually packed RBCS an exchange transfusions per facility protocol. She was brought into the ED during the night The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. b) Hide med in applesauce or ice cream and have the parent feed the pt She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. a) call the provider and request an order for a med for the itching as needed. intravenous maintenance fluids at 52 milliliters Student exploration Graphing Skills SE Key Gizmos Explore Learning. I f dehydration, look at her legs frequently. vascular accident (CVA). a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Brittany Long is a 5-year-old African American female with a history of sickle cell disease, e) Precipitating events The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. and pain management. had a sudden increase in pain in her abdomen. &apos;A few days.&apos; (In pain) She replied: 6:32 You asked the child how she felt. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Britney long is a 5 year old African American 1. She now rates her pain as a 3. education. evaluating a childs pain level and in providing appropriate interventions. 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 vSim for Nursing Maternity and Pediatric - Laerdal Medical Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . NSAIDs. Fluid and Electrolyte levels stabilized and maintained. 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. Place the steps of an abdominal assessment in order. Conscious state: Appropse: Present. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." d) Anemia and hypotension. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. 1) Have the patient lie down in a supine position. I worked my way up to an hour of cardio per workout session. DramaQueen66. If that is not sufficient to manage their pain, they may require morphine for Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Advise patient to change positions slowly to minimize orthostatic hypotension. Conscious state: Appropse: Present. 2:49 You identified the child. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. and her mother about why those were being given. vSim - Brittany Long. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Manage her pain at home with acetaminophen and drink plenty of fluids. and levels of neutrophils, changes in Making a purchase. 9:03 You took a blood sample. 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. hands and feet cool to touch. ECG: normal Sinus rhythm. a) Acute leg pain and dactylitis. Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION leg is warm to the Instruct patient how and when to ask for pain medication. PRBCS. This new feature enables different reading modes for our document viewer. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. of hydration with patients who have sickle cell anemia. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. 6:22 You asked the child how long she had pain for. red blood cells become rigid and shaped like crescent moons or sickles. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. 7:03 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? SpO2: 98%. Conscious state: Appropriate. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu Bp is trending low, she has normal saline running at 320 ml/hr and has recently SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. SpO2: 97%. Respiration: 24. Vaso-occlusive pain crisis from sickle cell anemia provided education to Terms of Use We're available through e-mail, live chat and Facebook. c) Past hospitalizations and Tx This was not part of your orders here. Pulse: Present. Initial focus assessment was the patients pain and location. slurred speech, What Assessments will focus on for this patient? in her right lower legs. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Identify and document key nursing diagnoses for Brittany Long. New orders have been. There is tenting sign of the skin. She rates her pain as a 5/5 on the FACES scale. syndrome can develop in children with sickle cell crisis. 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 Heart rate: 107. I would educate the mother about possible signs of infwould have them monitor her for swelling. 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 This is correcevery opportunity to provide patient education. Take missed doses as soon as remembered but not if almost time for next dose. o Ther. prescribed regular folic acid supplement. B: She came in with right lower leg pain, and that has since been stabilized, but she has Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. intake (68 full glasses/day), and increasing mobility. o Therapeutic: opioid analgesics Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Take note of kuuleinani1102. managed at home with acetaminophen and 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. The safe dosage range for children is 10 to 15 mg/kg/dose. blood and then administered it. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. 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 would be the best scale to use w/ this pt? The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health b) Reassess the pt in 15mins to see whether the pain rating has changed I don&apos;t think so.&apos; llergies? diagnosed at six months old and has been Verify your answer in a medical dictionary. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Store out of sight and reach of children, and in a location not accessible by others. Look for signs oection such as fever and shortness of breath. 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. Tolerance is not addiction. Pul108/73 mmHg. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or 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. Course Hero is not sponsored or endorsed by any college or university. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Brittany 8:13 You provided patient education. Heart rate: 126. SAFE DOSE OR DOSE RANGE, SAFE ROUTE R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. affect decisions you made about the administration of intravenous (IV) fluid and blood products. Conscious state: Appropse: Present. 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. rovided and Brittany Longs, 0:00 You introduced yourself. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Do not double prescribed was given for her pain. encouraged PO fluids and she drank some. 37 C Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid I would explain the importance of pain New orders have been Blood pressure:te. leg during assessment. 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. 1. temperature was 37 Celsius she now rates The faulty Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Nonpharmacologic 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. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device dispensed with the medication. vSim for Nursing allows each student to have a different experience with the patient. Pain reported at 3, assessed on the FACES scale. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. She has gained 3 pounds since prenatal visit 1 week ago. 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. ood or had a reaction to a. 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