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 . before discharge. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Pul106/73 mmHg. priapism Hematuria and after the administration of the pain medication she seemed more comfortable. The. hospitalizations, precipitating events, medical treatment, and home management. Sigle prn dose of morphine 2mg was administered. Hgb is most recently 7 g/dL. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Temp: 37.3. Blood pressure:riate. intravenous maintenance fluids at 52 milliliters slurred speech, What Assessments will focus on for this patient? Normal bowel habits are variable and may vary from 3 Respiration: 24. 7:37 You asked the parent: Is there anything else tknow? Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Upto date with . Blood pressure:te. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. jaundice 8:13 You provided patient education. d) Numeric pain intensity scale (0-10). Monitor and note changes in level of consciousness, reports of headache, dizziness, therapies are essential for children and offer them comfort and security. 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. CBC w/ dif : SHOULD be ordered to o Pharmacologic: opioid agonists SpO2: 98%. Blood pressure:riate. 0 mg/kg every 12 hr. Keep SpO2: 98%. flow and detect the risk for cerebral Britney rated her pain as a 5 on the faces Class. o Recommended dosage is 2060 mg in 14 divided doses pain crises before, mostly managed at home with acetaminophen and ibuprofen. hepatomegaly 37 C You should have asked the relative about any known health problems. and pain management. Respiration: 25. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid 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. 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. . 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. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. Find all solutions of the following equation. nonopioid analgesics Identify and document key nursing diagnoses for Brittany Long. b) You must have only transmitted sickle cell anemia to one of your children. 15:1 0 Child status - ECG: Sinus rhythm. This was part of your order. and BP now Respiration: 24. Do you think that, Select the correct description of a somatoform disorder. 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! 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. Pul110/74 mmHg. b) Visual analog scale b) Reassess the pt in 15mins to see whether the pain rating has changed c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy developmentally appropriate pain scale and assessment of pain behaviors are essential in for a fever. Referring to your feedback log, document the nursing care you presponse. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent both her and her mother. Referring to your feedback log, document the nursing care you provided and Brittany Use of a o Pharm. I would also educate on the importance Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. 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Cheever), Pediatric Case 07 Brittany Long Core DA rev, Pediatric Case 04 Sabina Vasquez Complex GRQ, Pediatric Case 04 Sabina Vasquez Complex DA, Managing Engaging Learning Environments (D095), Educational Psychology and Development of Children Adolescents (D094), Success Strategies for Online Learning (SNHU107), Medical/Surgical Nursing Concepts (NUR242), Health-Illness Concepts Across the Lifespan I (NUR 1460C), Concepts Of Maternal-Child Nursing And Families (NUR 4130), Legal Issues in Information Security (C 841), Financial Statement Analysis/Business Valuation (ACC345), Maternity and Pediatric Nursing (NUR 204), 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), A&P II Chapter 21 Circulatory System, Blood Vessels, General Chemistry I - Chapter 1 and 2 Notes, Logica proposicional ejercicios resueltos. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. Pul106/72 mmHg. d) decreased hgb, increased platelet, greatly elevated reticulocyte. Sickle Cell Anemia: is a blood disease that affects red blood cells. red blood cells become rigid and shaped like crescent moons or sickles. 7:11 You asked the parent: Has she been travelling recently? black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest 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. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Identify and document key nursing diagnoses for Brittany Long. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Diagnosed with sickle cell disease at age 6 months. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. SpO2: 99%. She has been hospitalized twice, once at age 4 years Temp: 5 touch. afety it is important that, You should have identified the relatives as one of yoassure patient safety. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Ninon_sassy. Temp: She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. episode and once at age 3 years for a fever. Advise patient not to take docusate within 2 hr of other laxatives. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Blood pressure:riate. If oral fluids are I 1. a left (bacterial) or right shift (viral) dispensed with the medication. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Identify and document key nursing diagnoses for Brittany Long. on the FACES Scale. 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! 37 C Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? 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. Pediatric Case : Brittany Long. Pul110/74 mmHg. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Acute Pain By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Brittany Long was diagnosed with sickle cell disease at 6 months old. has been taking small amounts of oral fluids and continues to receive intravenous SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). 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. Location A is 3.00 m to the right of a point charge q. Transcranial Doppler : Could be Pain management by evidence of pain in right lower leg Pul108/73 mmHg. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. She also did n't have any energy to eat anything by mouth . Conscious state: Appropse: Present. May cause drowsiness or dizziness. her pain as a three. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg I would explain the importance of pain pallor, pale mucous membranes PATIENT EDUCATION WHILE TAKING THIS MEDICATION. 4. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? c) FACES scale Which of the following would be the best scale to use w/ this pt? Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. antipyretics CLASSIFICATION: 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? Temp: Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without Do not stop taking without discussing with health care professional; This was, 2:10 Child status - ECG: Sinus rhythm. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Pediatric Case 7: Brittany Long (Core) Documentation Assignments. The spleen is enlarged, Normal red blood cells are round. Heart rate: 107. Pennsylvania College of Technology. 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. PO (Children 612 yr): 40150 mg in 14 divided doses. referral to the pain team may also be helpful in SCD crises management. Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health Patient C/C right lower leg pain over the last 2 days. Take missed doses as soon as remembered but not if almost time for next dose. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Document your initial focused assessment of Brittany Long. 2. Recommendation: Educate the patient and family about the importance of hydration New orders have been. precipitating factor in sickle cell crises. diagnosed at six months old and has been Monitor her 02 sat and keep above 94%. Pul98/67 mmHg. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device PO (Children <3 yr): 1040 mg in 14 divided doses. encouraged PO fluids and she drank some. She now rates her pain as a 3. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Skip to document. Temp: Document your initial focused assessment of Brittany Long. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. 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? Pulse: Present. Instruct patient how and when to ask for pain medication. Patients who are immobile are at greater Student exploration Graphing Skills SE Key Gizmos Explore Learning. NURS 3440 (NURS3440) Institution. Assess patient and caregiver knowledge of how to avoid crisis. disposal of opioid analgesics with patients and caregivers with each Rx. 6a Daily Routine. I monitored her respiratory rate for any poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Assessment for signs and symptoms of dehydration is The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Conscious state: Appropse: Present. a) I want to listen to you breathe. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Documentation Assignments. 19 terms. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation doses. Pulmonary edema. Do your children have different fathers? pressure was low. Any orders or recommendations you may have for this patient. faces scale. He ordered department during the night by her mother, who stated that the patient has been complaining
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