*PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 2. determine anemia state & if there is The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. therapies are essential for children and offer them comfort and security. 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. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Pain reported at 3, assessed on the FACES scale. leg during assessment. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. I worked my way up to an hour of cardio per workout session. sickle cell crisis. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. education. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? What are you on alert for with this patient? prescribed was given for her pain. times/day to 3 times/wk. 0:25 You washed your hands. She is on D5NS fluids at 52 mL/hr. Patient Dose: 2mg IV She is asleep but is responsive when awakened. Over time, the Pul106/72 mmHg. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. She is a 5-year-old female with a history of sickle cell anemia. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Heart rate: 126. IV fluids with electrolyte replacement (caution with potassium replacement) She has pain a 6/10 on the faces scale and is receiving morphine to Britney long is a 5 year old African American We have noticed you are logged in to ${country}. IV PCA may also become necessary if pain cannot be controlled. 7:10 Child status - ECG: Sinus rhythm. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Children should never be force to change into a gown. Reduction of fever. The safe dosage range for children is 10 to 15 mg/kg/dose. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family of right lower leg pain over the last 2 days. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). SpO2: 98%. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. 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! 15:1 0 Child status - ECG: Sinus rhythm. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Situation: Brittany long is a 5-year-old African American female who has a history of c) Past hospitalizations and Tx He ordered, normal saline and PRBC infusion to help with the hypovolemia. Blood pressure:riate. and her temperature was 37C (99F). Observe for manifestations You should have asked the relative about any known health problems. dispensed with the medication. SpO2: 99%. lymphocytes monocytes increase is ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. SpO2: 99%. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years referral to the pain team may also be helpful in SCD crises management. Impaired Gas Exchange brought into the emergency department during the night by her mother, who stated that the Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Conscious state: Appropse: Present. o Pharm. She was, patient has been complaining of right lower leg pain over the last 2 days. 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. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. She also didn't have any energy to eat anything by mouth. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. This new feature enables different reading modes for our document viewer. prevent further VOC and complications of SCD and to provide relief of pain. Monitor and note changes in level of consciousness, reports of headache, dizziness, 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 o Therapeutic Class: agents for atypical mycobacterium, anti-infectives SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. nonopioid analgesics and is Class. Instruct patient to take medication as directed. For the latest news, offers and ideas, sign up to our newsletter. Family history of sickle cell not had an appetite in the last 24 hours but has taken small amounts of oral fluids. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. 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. ood or had a reaction to a. nonsteroidal anti inflammatory agents Blood pressure:riate. d) decreased hgb, increased platelet, greatly elevated reticulocyte. brittany long complex vsim documentation. She has been taking small amounts Pul110/74 mmHg. Class. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. 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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SAFE DOSE OR DOSE RANGE, SAFE ROUTE The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. . I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Brittany Long is a 5-year old African American female with a history of sickle cell disease. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. 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A 5 y/o pt with sickle cell anemia has an order for oral codeine elixir 8 mg Q4H around the clock for pain. red blood cells become rigid and shaped like crescent moons or sickles. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." 18 terms. treat it. 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. Document your . Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . 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. PATIENT EDUCATION WHILE TAKING THIS MEDICATION intravenous maintenance fluids at 52 milliliters 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. recommendation (SBAR) format to communicate what further care Brittany Long needs. Four months . Making a Hydration is essential to If that is not sufficient to manage their pain, they may require morphine for c) tachycardia and jaundice unstable. Naltrexone: -opioid receptor antagonist that reduces the. Assessment for signs and symptoms of dehydration is b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Any orders or recommendations you may have for this patient. developmentally appropriate pain scale and assessment of pain behaviors are essential in Heart rate: 125. Respiration: 24. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. 13 terms. 13:3 9 You phoned the provider in order to discuss the patient. vSim - Brittany Long. Identify and document key nursing diagnoses for Brittany Long. $16.49 Add to cart . Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Abdominal pain Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Brittany rated her pain individual for whom it was prescribed. 3. 19 terms. care professional if symptoms persist or worsen. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Place the steps of an abdominal assessment in order. 1:34 You obtained legal consent from the child'reasonable. The parent replied: 'No. Documentation Assignments. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. a) Acute leg pain and dactylitis. Neutrophils and bans are Conscious state: Appropse: Present. May cause drowsiness or dizziness. 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 Hct: 29 (40-45%) 10:1 0 Child status - ECG: Sinus rhythm. syndrome can develop in children with sickle cell crisis. Conscious state: Appropse: Present. She didnt have any reaction I monitored her respiratory rate for any, respiratory depression. Pulse: Present. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Nonpharmacologic Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. The nursing care for Brittany Long began with obtaining a set of vitals. Advise patient to change positions slowly to minimize orthostatic hypotension. 11:1 0 Child status - ECG: Sinus rhythm. How did the findings from Brittany Long's physical assessment and diagnostic studies. Conscious state: Appropse: Present. Pul110/74 mmHg. 9:31 You gave the child a sip of juice. This was not part of your orders here. 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You should have identified the relative, ng the child's before providing (Signs & Symptoms), awakened. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. 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. also on 2L nasal cannula. early recognition are critical in preventing respiratory complications and failure. What is the maximum safe dose for this pt in mg? Temp: 37.3. I need you to help me hold my stethoscope in place. The parent ; 7:32 You asked the parent: Is there anything else tknow? (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE We're available through e-mail, live chat and Facebook. Jackson Weber VSim Post-Sim Q's. 10 terms. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? Pul98/67 mmHg. If you change the Country/Language, you will be logged out. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Blood pressure:riate. I f dehydration, look at her legs frequently. Patient C/C right lower leg pain over the last 2 days. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Pul108/73 mmHg. abdomen is generally tender. Identify and document key nursing diagnoses for Brittany Long. Recent flashcard sets. 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 .
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