Would you like to proceed ? To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Respiration: 24. Many OTC products contain ibuprofen; avoid duplication. I have given her morphine 2 mg IV Push and have also bolused TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? __________mg. signs Q2 hours. Use preservative-free formulation. She has had pain crises before, mostly managed at b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Conscious state: Appropriase: Present. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. This is reasonable. avoid a sickle cell crisis in the future. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. 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. 37 C Pul106/73 mmHg. pressure was low. Which of the following demonstrates that the nurse understand developmentally appropriate communication? : 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. o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). Child Life can assist in making the child comfortable and regulating anxiety levels. Hydration is essential to Transcranial Doppler : Could be 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. Pain level controlled and maintained, avoiding. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? 0 mg/kg every 12 hr. care professional if symptoms persist or worsen. Conscious state: Appropse: Present. pallor, pale mucous membranes 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. 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New orders have been This is correcevery opportunity to provide patient education. viral. Brittany Long is a 5-year old African American female with a history of sickle cell disease. 6:22 You asked the child how long she had pain for. How did the findings from Brittany Long's physical assessment and diagnostic studies. Describe the actions you felt went well in this scenario. May cause drowsiness or dizziness. Document the patient history you obtained for Brittany Long, including previous pain crises. 1) Have the patient lie down in a supine position. in her right lower legs. 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! 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. Note that the wording of the dictionary definition may vary from the wording below. Which of the following responses by the nurse is correct? a) Sickle cells cause increased blood flow throughout the body. Are you considering implementing vSim for Nursing into your existing curricula? A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. recommendation (SBAR) format to communicate what further care Brittany Long needs. Children should never be force to change into a gown. Initial focus assessment was the patients pain and location. Neutrophils and bans are Advise patient to change positions slowly to minimize orthostatic hypotension. hours but has taken small amounts of oral Electrolytes Promote rest to decrease oxygen consumption. 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. 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. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Heart rate: 127. sickle cell disease. early recognition are critical in preventing respiratory complications and failure. and levels of neutrophils, changes in Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Obstructive jaundice episode and once at age 3 years for a fever. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. I Temp: 5 touch. 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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? PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily Background: Brittany Long has a history of sickle cell anemia being treated with a folic Respiration: 24. 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IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or temperature was 37 Celsius she now rates A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. hepatomegaly PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. 15 x 16 = 240. SAFE DOSE OR DOSE RANGE, SAFE ROUTE has been taking small amounts of oral fluids and continues to receive intravenous and the abdomen is generally tender. Which of the following explanations b the nurse is correct? 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! Controlled-release tablet 0 I have a weekly show-- Ease Into . Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. c) Ask the parent whether the pt is hurting SpO2: 99%. 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. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Circulating sickle cells are hemolysized by the. The nurse is teaching Brittany how to use the FACES scale to rate pain. Conscious state: Appropse: Present. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. Blood pressure:riate. Sets found in the same folder. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest evaluating a childs pain level and in providing appropriate interventions. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. She 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. o Pharm. Respiration: 24. 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. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Signs of stroke i. TCD is performed annually on PO (Children 11 yr/7295 lb): 300 mg every 68 hr. 7:10 Child status - ECG: Sinus rhythm. Pre/Post Simulation for Brittany Long. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: vSim - Brittany Long. Identify and document key nursing diagnoses for Brittany Long. priapism provided education to Skip to document. Brittany rated her pain SpO2: 98%. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. She was brought into the emergency 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. Pul109/74 mmHg. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. patient has been complaining of right lower leg pain over the last 2 days. Pul108/73 mmHg. played with and became more comfortable with. CBC w/ dif : SHOULD be ordered to A 5 y/o is old enough to accurately report his or her own pain level and may be lying still as a coping strategy of bc the movement is painful. times/day to 3 times/wk. d)Enuresis and proteinuria. PO (Children 612 yr): 40150 mg in 14 divided doses. 18 terms. The parent, 3:10 Child status - ECG: Sinus rhythm. once at age 4 years for vaso-occlusive crisis and after the administration of the pain medication she seemed more comfortable. Pulse: Present. Her pain was a 3/5 on FACES scale The breath sounds are clear and equal bilaterally. The. 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 . 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. Respiration: 24. slurred speech, What Assessments will focus on for this patient? Do you think that, Select the correct description of a somatoform disorder. What are you on alert for with this patient? Educate patient and family on nutritional and fluid needs. 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. education. Blood pressure:riate. VSim Charlie Snow Complex Pre/Post Sim. hands and feet cool to touch. 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. VBVA=45.0V. 3. Neutrophils and bans are bacterial. a) Sickle cell anemia is transmitted through he father. o Pharmacologic: opioid agonists a) Administer the prescribed analgesic as ordered a) Acute leg pain and dactylitis. d) You need to change into hospital gown before I can examine you. With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. had a sudden increase in pain in her abdomen. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Disulfiram: NMDA receptor antagonist & GABAA agonist B . Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. PO Infants: 5 mg/kg/day in 14 divided doses. nonopioid analgesics Document your initial focused assessment of Brittany Long. NS and PRBCs. Monitor her pain levels. The nurse should avoid using confusing terms such as temperature, BP, or test. faces scale. Referring to your feedback log, document the nursing care you provided and Brittany Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Heart rate: 126. Examined the leg and it was warm. Hypovolemia by evidence of pale extremities Brittany was given oral pain medication in the emergency department at 6:00 AM. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. emergency Department at 0600. c) Morphine bc the pt reports severe pain. 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. 15:1 0 Child status - ECG: Sinus rhythm. Respiration: 24. determine anemia state & if there is scale and did not want anyone to touch her Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Document your initial focused assessment of Brittany Long. This was not part of your orders here. Hypertension and tachycardia are often associated with acute pain. atelectasis. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. Recommendation: Educate the patient and family about the importance of hydration Maintain adequate fluid intake and monitor urine output. individual for whom it was prescribed. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. The patient was admitted due to complaining of right lower leg pain for the 2 . From vSim for Nursing | Pediatric. Management of Care: What needs to be done for this Patient Today? pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. 1. b) Anemia and hypotension dizziness The padon't think so.' rent replied: 'No. 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. 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. To maintain patient syou quickly identify the child. 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. Her skin is quite cold. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. The nurse is reviewing lab data on a pt with sickle cell anemia. Making a 1:34 You obtained legal consent from the child'reasonable. Student exploration Graphing Skills SE Key Gizmos Explore Learning. IV Neonates: Continuous infusion 00 mg/kg/hr. School Herzing University; Course Title PN 124; Uploaded By hana254830. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Conscious state: Appropse: Present. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. and is Identify and document key nursing diagnoses for Brittany Long. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? 9:31 You gave the child a sip of juice. regular heart sounds without murmurs. This was, 2:10 Child status - ECG: Sinus rhythm. Class. vSim - Brittany Long. Assess dehydration status via CBC, Urinalysis and strict I/O. referral to the pain team may also be helpful in SCD crises management. 1. Document the patient history you obtained for Brittany Long. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . hidy_esther. I monitored her vitals 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. 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? Pul98/67 mmHg. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? I verified with two nurses in regard to the 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. DramaQueen66. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Sickle Cell Anemia: is a blood disease that affects red blood cells. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis.