encouraged PO fluids and she drank some. Monitor and note changes in level of consciousness, reports of headache, dizziness, The patient was admitted due to complaining of right lower leg pain for the 2 . Conscious state: Appropse: Present. of infection and dehydration, and pain management. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. acid supplement taken daily. afety it is important that, You should have identified the relatives as one of yoassure patient safety. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. SpO2: 99%. Blood pressure:riate. 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. (In pain) She. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Advise patients that laxatives should be used only for short-term therapy. hepatomegaly A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. dizziness She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. SpO2: 98%. Discuss safe use, risks, and proper storage and Document your initial focused assessment of Brittany Long. episode and once at age 3 years for a fever. are inadequate (extended release). If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. and educated the mother about signs of a reaction. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest 13:3 9 You phoned the provider in order to discuss the patient. flow and detect the risk for cerebral Temp: c) Ask the parent whether the pt is hurting Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. You should have identified the relative, ng the child's before providing Acute chest Signs of stroke i. Before discharging Brittany Long and her family, I would educate them on how to shortness of breath, fatigue Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid arcoca . c) Past hospitalizations and Tx Britney rated her pain as a 5 on the faces Reduction of fever. pallor, pale mucous membranes Transcranial Doppler : Could be Diagnosed with sickle cell disease at age 6 months. (Signs & Symptoms), awakened. May cause drowsiness or dizziness. Fanny373. Temp: hhulsey6. 26% Which of the following explanations b the nurse is correct? Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS), Sickle Cell Anemia: is a blood disease that affects red blood cells. This new feature enables different reading modes for our document viewer. Document the patient teaching that you would provide for Brittany Long and her family may cause withdrawal symptoms if discontinued abruptly after prolonged use. 1. Abdominal pain The pt is lying quietly in bed watching TV. by her mother, who stated that the patient PURPOSE FOR TAKING THIS MEDICATION, Treatment of: Upto date with . Family history of sickle cell and pain management. If you change the Country/Language, you will be logged out. 15:1 0 Child status - ECG: Sinus rhythm. d) Anemia and hypotension. Do not double slurred speech, What Assessments will focus on for this patient? per hour period when examined this morning assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Conscious state: Appropse: Present. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: 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. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Her pulse measured 160bpm, her respirations were 34, and her blood Would you like to proceed ? Pul109/74 mmHg. not meeting the childs fluid requirements, IV fluids are necessary. Normal red blood cells are round. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. 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? 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 crisis. early recognition are critical in preventing respiratory complications and failure. Her pain was a 3/, in her right lower legs. used to assess Intercranial vascular Do you think that, Select the correct description of a somatoform disorder. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. given. c) Morphine bc the pt reports severe pain. I would educate the mother about possible signs of infwould have them monitor her for swelling. She Antipyretic 5 mg/kg for hidy_esther. of right lower leg pain over the last 2 days. Her skin is quite cold. SAFE DOSE OR DOSE RANGE, SAFE ROUTE a) Administer the prescribed analgesic as ordered (Select all that apply), a) Assess pain frequently and administer meds routinely. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. atelectasis. The potential difference between the two locations is. Blood pressure:te. She has been hospitalized twice, once at age 4 years 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. I do about 40 minutes of it five times a week. She was admitted to the Pediatric unit this morning . Patients who are immobile are at greater Britney was given oral pain medication in the VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. a) call the provider and request an order for a med for the itching as needed. He ordered, normal saline and PRBC infusion to help with the hypovolemia. Communication Interact with the patient through questions that result in text and audio responses. Children should never be force to change into a gown. 6:22 You asked the child how long she had pain for. during my initial focused. Identify and document key nursing diagnoses for Brittany Long. 13 terms. has been complaining of right lower leg pain Blood pressure:riate. 37 C antirheumatics MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) What is the magnitude and sign of the charge? Skip to document. SpO2: 98%. brought into the emergency department during the night by her mother, who stated that the Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Heart rate: 127. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Electrolytes prevent further VOC and complications of SCD and to provide relief of pain. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. Recent flashcard sets . Protect it from theft, and never give to anyone other than the Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Do not stop taking without discussing with health care professional; The nurse is assessing for which of the following complications of vast-occlusive crisis? __________mg. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Conscious state: Appropriase: Present. Caution patient to call for assistance when ambulating a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. She didnt have any reaction Background: Brittany Long has a history of sickle cell anemia being treated with a folic Blood pressure:riate. Hence, his ministry is inclusive and hope-bearing. She also didn't have any energy to eat anything by mouth. Acute Pain VSim Brittany Long Pre/Post test. Patient C/C right lower leg pain over the last 2 days. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. abdomen is generally tender. I then preformed an assessment on her abdomen. X SAFE DOSAGE Her Wolters Kluwer Health. 37 C Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Use preservative-free formulation. Heart rate: 127. The child looked slightly Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. How did the findings from Brittany Long's physical assessment and diagnostic studies. Over time, the I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? nonopioid analgesics 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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What is the maximum safe dose for this pt in mg? The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. 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 Take missed doses as soon as remembered but not if almost time for next dose. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Do your children have different fathers? 2. of hypervolemia and transfusion reaction. 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. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). $16.49 Add to cart . Management of Care: What needs to be done for this Patient Today? Swollen joints, hands and feet before discharge. Hydration is essential to Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. home with acetaminophen and ibuprofen. e) Precipitating events. In people with sickle cell 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. Koehler), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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Conscious state: Appropse: Present. 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. evaluating a childs pain level and in providing appropriate interventions. Brought into the ED by her mother last night. Any orders or recommendations you may have for this patient. of oral fluids and continues to receive and after the administration of the pain medication she seemed more comfortable. Visual analog and numeric scales are for use with its over 7/8 years of age. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Advise patient not to take docusate within 2 hr of other laxatives. Respiration: 24. pressure was low. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? Which of the following would be the best scale to use w/ this pt? 13 terms. I A step-by-step guide to craft a winning sales presentation . education. o Pharm. 10:1 0 Child status - ECG: Sinus rhythm. leg is warm to the 18 terms. for a vaso-occlusive crisis episode and once at age 3 years for a fever. A. - fibers, The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life.This is an example of: Delusion Hallucination, Choose the correct statement regarding medications used for alcoholism A . Pulmonary edema. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. 37 C Pul110/74 mmHg. Class. Heart rate: 126. Pulse: Present. 2. 19 terms. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Identify and document key nursing diagnoses for Brittany Long. I f dehydration, look at her legs frequently. Heart rate: 109. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. Blood pressure:riate. c) FACES scale She has had pain crises before, mostly managed at Document your initial focused assessment of Brittany Long. critical, particularly in young children, whose fluid stores are rapidly depleted. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . 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. Blood pressure:riate. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Brittany VSIM. SpO2: 99%. Are you considering implementing vSim for Nursing into your existing curricula? development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE 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. I called her provider to see what else I should do. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. : 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. (In pain) She well' replied: 'Not too. brittany long vsim step by step. (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? 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. b) Hide med in applesauce or ice cream and have the parent feed the pt 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. NURS 3440 (NURS3440) Institution. Continuous infusion, sickle cell or cancer This was, 2:10 Child status - ECG: Sinus rhythm. Conscious state: Appropse: Present. 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. Examined the leg and it was warm. 15 x 16 = 240. 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! 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. a) I want to listen to you breathe. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, The spleen is enlarged, hospitalizations, precipitating events, medical treatment, and home management. Respiration: 24. Class. New orders have been The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 3. She now rates her pain as a 3. Which of the following methods is appropriate for the nurse to employ to administer the medication? I monitored her respiratory rate for any, respiratory depression. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options I stayed to watch for a transfusion reaction. I also started incorporating more strength training into my gym routine. CLASSIFICATION: nonopioid analgesics Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. On inspection, the pt's skin is flat & w/o erythema. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. The nursing care for Brittany Long began with obtaining a set of vitals. 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. hours but has taken small amounts of oral risk for this complication. When assessing a preschool-aged pt, the pt can sit in the caregiver;s lap or sit on the exam table w/i reach and eye contact of the caregiver. 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 the last 2 days. Creatinine: 0 (0.8-1). anemia or sickle cell trait d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. 7:11 You asked the parent: Has she been travelling recently? I have a weekly show-- Ease Into . . 8:10 Child status - ECG: Sinus rhythm. 8:13 You provided patient education. 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 . 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I
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