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 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. SpO2: 98%. 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 . PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. tired. Are you considering implementing vSim for Nursing into your existing curricula? Heart rate: 128. (Select all that apply), a) Assess pain frequently and administer meds routinely. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 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? Identify and document key nursing diagnoses for Brittany Long. You don't have to be crying to be hurting a lot. arcoca . Temp: 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. before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation 2. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. diagnosed at six months old and has been In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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? Do not stop taking without discussing with health care professional; Pennsylvania College of Technology. She has been A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Heart rate: 126. 2400 mg/day, whichever is less). Documentation Assignments. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Visual disturbances. 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. 0 mg/kg every 12 hr. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. emergency Department at 0600. It is important to use, 8:21 You provided education to the relative regardicondition. Protect it from theft, and never give to anyone other than the Document your initial focused assessment of Brittany Long. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. and levels of neutrophils, changes in used to assess Intercranial vascular encouraged PO fluids and she drank some. prevention of infection and dehydration, and pain management. 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. Hematuria brittany long complex vsim documentation. Brittany Long Vsim Location: Emergency department 7 AM 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. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. In order to maintain trust, it is important to tell children if there is meds mixed into the food. hidy_esther. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. s relative. Respiration: 24. This is reasonable. 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Wolters Kluwer Health. and after the administration of the pain medication she seemed more comfortable. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. anemia or sickle cell trait 18 terms. She is asleep but is responsive when arcoca. Temp: Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. She rates her pain as a 5/5 on the FACES scale. It is not necessary to give combining terms for words in parentheses. (In pain) She well' replied: 'Not too. She was brought into the emergency department during the night by her mother, who stated that the patient has been complaining of right lower leg pain over the last 2 days. IV Neonates: Continuous infusion 00 mg/kg/hr. Conscious state: Appropse: Present. Acute chest 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Pain reported at 3, assessed on the FACES scale. Store out of sight and reach of children, and in a location not accessible by others. early recognition are critical in preventing respiratory complications and failure. VSim Brittany Long Pre/Post test. CLASSIFICATION: Temp: Abdominal pain o Recommended dosage is 2060 mg in 14 divided doses Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Any orders or recommendations you may have for this patient. Reticulocytes 5 (0.5-1%) IV fluids with electrolyte replacement (caution with potassium replacement) Sickle Cell Anemia: is a blood disease that affects red blood cells. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Blood pressure:riate. c) tachycardia and jaundice Class: macrolide closely monitor laboratory results reporting any notable , out of range levels , NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE, MEDICATION: Morphine sulfate 2 mg IV (o mg/kg/dose) X 1 awakened. c) Past hospitalizations and Tx 19 terms. You should have identified the relative, ng the child's before providing Manage her pain at home with acetaminophen and drink plenty of fluids. greenstickynotes. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids ibuprofen. Sigle prn dose of morphine 2mg was administered. Neutrophils and bans are The nurse is teaching Brittany how to use the FACES scale to rate pain. education. 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Temp: The purpose of my YouTube channel is to empower my viewers with the information they need to start, plan, organize and implement evergreen email sequences. pain 02 mg/kg/hr. In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. syndrome can develop in children with sickle cell crisis. I then did a I would educate the mother about possible signs of infwould have them monitor her for swelling. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: Decreased pain and inflammation. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Pul98/67 mmHg. 14:1 0 Child status - ECG: Sinus rhythm. Heart rate: 126. b) Hide med in applesauce or ice cream and have the parent feed the pt 37 C 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. Referring to your feedback log, document the nursing care you provided and Brittany What action should the nurse take? She has Her pain was a 3/5 on FACES scale c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy 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). c) Enuresis and proteinuria. May cause drowsiness or dizziness. Instruct patient how and when to ask for pain medication. d) Anemia and hypotension. Pul106/72 mmHg. antirheumatics She was brought into the ED during the night Pul106/73 mmHg. ven over 30 minutes. 37 C Making a 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. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 13:3 9 You phoned the provider in order to discuss the patient. She looked visually uncomfortable and reported feeling pain, a 6/10 on the SpO2: 97%. I Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Sets found in the same folder. a) Choose the face that looks like how you feel inside. d) Frequency of vaso-occlusive crises 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. Labs; daily complete blood count 7:11 You asked the parent: Has she been travelling recently? Monitor her pain levels. Creatinine: 0 (0.8-1). Document your initial focused assessment of Brittany Long. Upto date with . 37 C respiratory depression. PATIENT EDUCATION WHILE TAKING THIS MEDICATION pain, shortness of breath, weakness, slurring of speech) occurs. Over time, the Blood pressure:riate. SpO2: 99%. hands and feet cool to touch. 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Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? Management of Care: What needs to be done for this Patient Today? c) Morphine bc the pt reports severe pain. 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. A step-by-step guide to craft a winning sales presentation . We have noticed you are logged in to ${country}. and her mother about why those were being given. Brought into the ED by her mother last night. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. Respiration: 24. Ineffective Tissue Perfusion Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. doses. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. department during the night by her mother, who stated that the patient has been complaining therapies are essential for children and offer them comfort and security. Patients who are immobile are at greater b) Family hx of blood transfusion Brittany was given oral pain medication in the emergency department at 6:00 AM. I also started incorporating more strength training into my gym routine. Hypertension and tachycardia are often associated with acute pain. normal saline and PRBC infusion to help with the hypovolemia. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Instruct patient to take medication as directed. Take note of by her mother, who stated that the patient PROTOTYPE: Aspirin She is on D5NS fluids at 52 mL/hr. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. I assessed her IV, asked for name and date of birth, and Normal red blood cells are round. provided education to Britney rated her pain as a 5 on the faces I f dehydration, look at her legs frequently. lymphocytes monocytes increase is SpO2: 98%. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device her blood pressure was 101 / 70 and her 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 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. children ages 2 to 16 years who have 20 terms. Severe pain, usually in bones Course Hero is not sponsored or endorsed by any college or university. (Clinical slides 02.02) I called her provider to see what else I should do. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis).