Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). jaundice c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy breakthrough pain. episode a) Sickle cells cause increased blood flow throughout the body. regular heart sounds without murmurs. Skip to document. Monitor O2 saturation levels managed at home with acetaminophen and Document your initial focused assessment of Brittany Long. Naltrexone: -opioid receptor antagonist that reduces the. ECG: normal Sinus rhythm. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Recent flashcard sets . She didnt have any reaction 18 terms. Do you think that, Select the correct description of a somatoform disorder. The safe dosage range for children is 10 to 15 mg/kg/dose. 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. : 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. 37 C IV PCA may also become necessary if pain cannot be controlled. Many OTC products contain ibuprofen; avoid duplication. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Heart rate: 126. And Hct. d) Anemia and hypotension. spleen, leading to anemia. d)Enuresis and proteinuria. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. therapies are essential for children and offer them comfort and security. a) Choose the face that looks like how you feel inside. Heart rate: 107. She is asleep but is responsive when Examined the leg and it was warm. Heart rate: 128. Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . When examined this morning, her blood pressure was 101/ 18 terms. Monitoring oxygenation, use of incentive spirometry, hydration, and 1. 10:1 0 Child status - ECG: Sinus rhythm. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. 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Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Four months . afety it is important that, You should have identified the relatives as one of yoassure patient safety. I verified with two nurses in regard to the s relative. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Pain management by evidence of pain in right lower leg Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. The padon't think so.' rent replied: 'No. CLASSIFICATION: The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. slurred speech, What Assessments will focus on for this patient? Pul106/72 mmHg. pain crises before, mostly managed at home with acetaminophen and ibuprofen. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. 19 terms. Acute chest prescribed regular folic acid supplement. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. I monitored her respiratory rate for any, respiratory depression. Temp: Pul106/73 mmHg. 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 Creatinine: 0 (0.8-1). Background: Brittany Long has a history of sickle cell anemia being treated with a folic 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Temp: Promote rest and provide adequate fluids and nutrition. every 34 hr, maximum: 15 mg/dose. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Deep. Pre/Post Simulation for Brittany Long. Blood pressure:riate. Brought into the ED by her mother last night. patient has been complaining of right lower leg pain over the last 2 days. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 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. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. The. encouraging fluids, she kept drinking as I gave her fluids. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. vSim - Brittany Long. The nurse is teaching Brittany how to use the FACES scale to rate pain. Verify your answer in a medical dictionary. 3. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Brittany VSIM. Brittany SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. c) FACES scale Document your handoff report in the situation-background-assessment- respiratory depression. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Brittany was given oral pain medication in the emergency department at 6:00 AM. Observe for manifestations c) Use a dropper to place med in back of the pt's throat (Select all that apply), a) Assess pain frequently and administer meds routinely. What is the maximum safe dose for this pt in mg? Wolters Kluwer Health. fluids. After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? Her skin is quite cold. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Continuous infusion, sickle cell or cancer 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 antipyretics faces scale. 2) Inspect abdomen for size and shape. brittany long complex vsim documentation. priapism Identify and document key nursing diagnoses for Brittany Long. provided education to 1:34 You obtained legal consent from the child'reasonable. 6:22 You asked the child how long she had pain for. Advise patients that laxatives should be used only for short-term therapy. Describe the actions you felt went well in this scenario. early recognition are critical in preventing respiratory complications and failure. acid supplement taken daily. I administered more fluids and PDA Closure has been taking small amounts of oral fluids and continues to receive intravenous Fanny373. 8:10 Child status - ECG: Sinus rhythm. Initial focus assessment was the patients pain and location. 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. developmentally appropriate pain scale and assessment of pain behaviors are essential in 9:03 You took a blood sample. Discuss safe use, risks, and proper storage and What action should the nurse take? Long-term therapy may cause Blood pressure:te. SpO2: 99%. Temp: c) tachycardia and jaundice her blood pressure was 101 / 70 and her Identify and document key nursing diagnoses for Brittany Long. (Signs & Symptoms), 3. children ages 2 to 16 years who have 9:31 You gave the child a sip of juice. Management of Care: What needs to be done for this Patient Today? PO (Children 612 yr): 40150 mg in 14 divided doses. IF you have four children, one or 25% will have sickle cell anemia. Pediatric OTC Dosing 2. He ordered Normal bowel habits are variable and may vary from 3 (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? She has been hospitalized twice, once at age 4 years Advise patient to inform health care professional of medication regimen prior to treatment or surgery. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Patients who are immobile are at greater line infusion rate to 52. PATIENT EDUCATION WHILE TAKING THIS MEDICATION 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. and educated the mother about signs of a reaction. She has had pain crises before, mostly nonopioid analgesics are inadequate (extended release). 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A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. awakened. 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 over the last 2 days. I/O can be calculated by UAP. Store out of sight and reach of children, and in a location not accessible by others. Sickle Cell Anemia: is a blood disease that affects red blood cells. This was not part of your orders here. 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, Infant, Child And Adolescent Nursing (NSG 441). Temp: allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. No known allergies, immunizations are up to date. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Diagnosed with sickle cell disease at age 6 months. Which of the following should the nurse do? Visual disturbances. vSim for Nursing allows each student to have a different experience with the patient. Bp is trending low, she has normal saline running at 320 ml/hr and has recently As blood flow is impaired by sickled cells, vasospasm occurs, further. leg during assessment. Initial focus assessment was the patients pain and location. Respiration: 25. 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. You don't have to be crying to be hurting a lot. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 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, Care of the childrearing family (nurs420). I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Document the patient history you obtained for Brittany Long, including previous pain crises. I educated the patient. Temp: 5 touch. c) I am going to take your temp. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. and basic metabolic panel, Blood analysis (notable): I assessed her IV, asked for name and date of birth, and for a vaso-occlusive crisis episode and once at age 3 years for a fever. intravenous maintenance fluids at 52 milliliters 3. o Ther. 7:10 Child status - ECG: Sinus rhythm. Her pain was a 3/, in her right lower legs. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. Pennsylvania College of Technology. Protect it from theft, and never give to anyone other than the It is important to use, 8:21 You provided education to the relative regardicondition.
Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION 14:1 0 Child status - ECG: Sinus rhythm. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Company Registration Number: 61965243 Heart rate: 127. Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, 9:10 Child status - ECG: Sinus rhythm. 26% 1 CHE101 - Summary Chemistry: The Central Science, Ethan Haas - Podcasts and Oral Histories Homework, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, PSY HW#3 - Homework on habituation, secure and insecure attachment and the stage theory, Lesson 17 Types of Lava and the Features They Form, 1010 - Summary Worlds Together Worlds Apart, Lessons from Antiquity Activities US Government, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, SCS 200 Applied Social Sciences Module 1 Short Answers, Greek god program by alex eubank pdf free, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Lab 3 Measurement Measuring Volume SE (Auto Recovered), Ati-rn-comprehensive-predictor-retake-2019-100-correct-ati-rn-comprehensive-predictor-retake-1 ATI RN COMPREHENSIVE PREDICTOR RETAKE 2019_100% Correct | ATI RN COMPREHENSIVE PREDICTOR RETAKE, 1-2 Module One Activity Project topic exploration, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, 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, Nursing Care of the Childbearing Family (NURS 125), Closely observe for manifestations of crisis and infection. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. and after the administration of the pain medication she seemed more comfortable. Normal red blood cells are round. of right lower leg pain over the last 2 days. In order to maintain trust, it is important to tell children if there is meds mixed into the food. on the FACES Scale.