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a) Acute leg pain and dactylitis. A step-by-step guide to craft a winning sales presentation . Brittany VSIM. of hypervolemia and transfusion reaction. I need you to help me hold my stethoscope in place. . in her right lower legs. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids I educated the patient. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Pain level controlled and maintained, avoiding. 0 mg/kg every 12 hr. 19 terms. developmentally appropriate pain scale and assessment of pain behaviors are essential in $16.49 Add to cart . Referring to your feedback log, document the nursing care you provided and Brittany 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. Respiration: 24. : 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. line infusion rate to 52. PO Infants: 5 mg/kg/day in 14 divided doses. diagnosed at six months old and has been 15:1 0 Child status - ECG: Sinus rhythm. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Hence, his ministry is inclusive and hope-bearing. of infection and dehydration, and pain management. are inadequate (extended release). Pul106/72 mmHg. NS and PRBCs. times/day to 3 times/wk. Look for signs oection such as fever and shortness of breath. (How will I identify the above signs &Symptoms?). her pain as a three. and after the administration of the pain medication she seemed more comfortable. CBC due Q 4 hours. Her pain was a 3/, in her right lower legs. department during the night by her mother, who stated that the patient has been complaining 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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Maintain adequate fluid intake and monitor urine output. Naltrexone: -opioid receptor antagonist that reduces the. We're available through e-mail, live chat and Facebook. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. c) Ask the parent whether the pt is hurting home with acetaminophen and ibuprofen. 7:11 You asked the parent: Has she been travelling recently? SAFE DOSE OR DOSE RANGE, SAFE ROUTE Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? He ordered, normal saline and PRBC infusion to help with the hypovolemia. Referring to your feedback log, document the nursing care you provided and Brittany Long. tired. I verified with two nurses in regard to the hidy_esther. greenstickynotes. Verify your answer in a medical dictionary. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. . development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. NURS 3440 (NURS3440) Institution. Hgb 9 (13.5-17) When obtaining a health hx on a pt with sickle cell anemia, the nurse should elicit info r/t growth and development, frequency of vaso-occlusive crises, Past hospitalizations and Tx for pain crises, immunization status, hx of blood transfusions, current medication regiment, and precipitating events. SpO2: 98%. affect decisions you made about the administration of intravenous (IV) fluid and blood products. Heart rate: 109. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Document your initial focused assessment of Brittany Long. (In pain) She. of right lower leg pain over the last 2 days. 2. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Blood pressure:te. Wolters Kluwer Health. There is tenting sign of the skin. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. 18 terms. 3. hepatomegaly individual for whom it was prescribed. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Document your . Making a purchase. Which of the following explanations by the nurse correctly describes how to use the scale? Pain management by evidence of pain in right lower leg Reticulocytes 5 (0.5-1%) PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Respiration: 24. She is a 5-year-old female with a history of sickle cell anemia. Pre/Post Simulation for Brittany Long. She has pain a 6/10 on the faces scale and is receiving morphine to DramaQueen66. I 15 x 16 = 240. Visual disturbances. PRBCS. Blood pressure:riate. VS can be monitored and reported by the UAP. I would also educate on the importance I/O can be calculated by UAP. Conscious state: Appropse: Present. awakened. I then did a Family history of sickle cell Labs; daily complete blood count TCD is performed annually on Temp: 37.3. : 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. c) Drinking to much water can trigger another crisis. (Clinical slides 02.02.2020), It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS). Brittany Long is a 5-year-old African American female with a history of sickle cell disease, The spleen is enlarged, 2) Inspect abdomen for size and shape. From vSim for Nursing | Pediatric. Document your initial focused assessment of Brittany Long. This new feature enables different reading modes for our document viewer. 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. SpO2: 99%. Jackson Weber VSim Post-Sim Q's. 10 terms. I Her Assessment for signs and symptoms of dehydration is afety it is important that, You should have identified the relatives as one of yoassure patient safety. determine anemia state & if there is prescribed was given for her pain. X SAFE DOSAGE Respiration: 24. 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 Respiration: 16. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Recent flashcard sets. The safe dosage range for children is 10 to 15 mg/kg/dose. pallor, pale mucous membranes In a vaso-occlusive crisis / painful CBC w/ dif : SHOULD be ordered to She rates her pain as a 5/5 on the FACES scale. arcoca . This was, 2:10 Child status - ECG: Sinus rhythm. 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. PATIENT EDUCATION WHILE TAKING THIS MEDICATION What is the maximum safe dose for this pt in mg? a left (bacterial) or right shift (viral) Jackson Weber Complex Pre/Post Quiz. vSim for Nursing: Pediatric Case 3: Eva Madis, NUR 307: VSim Sabina Vasquez Pre/Post test, Medical Condition in Pregnancy Part I HTN GDM, Fetal Assessment for Risk Factors (Exam 3), Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . encouraging fluids, she kept drinking as I gave her fluids. Ninon_sassy. Conscious state: Appropriate. Find all solutions of the following equation. Pul109/74 mmHg. Assess patient and caregiver knowledge of how to avoid crisis. sickle cell disease. every 34 hr, maximum: 15 mg/dose. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, atelectasis. PROTOTYPE: Morphine. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . This is correcevery opportunity to provide patient education. You must be logged in to submit this form. children ages 2 to 16 years who have emergency Department at 0600. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. antipyretics o Pharm. Bp is trending low, she has normal saline running at 320 ml/hr and has recently 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 Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Transcranial Doppler : Could be o Therapeutic Class: agents for atypical mycobacterium, anti-infectives Vaso-occlusive pain crisis from sickle cell anemia of oral fluids and continues to receive vSim - Brittany Long. Advise patient not to take docusate within 2 hr of other laxatives. Location B lies on the same line and is 4.00 m to the right of the charge. 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. Examined the leg and it was warm. PO (Children 36 yr): 2060 mg in 14 divided doses. School Herzing University; Course Title PN 124; Uploaded By hana254830. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. and her temperature was 37C (99F). Pul110/74 mmHg. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Creatinine: 0 (0.8-1). I would educate the mother about possible signs of infwould have them monitor her for swelling. and pain management. 240 for a fever. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Are you considering implementing vSim for Nursing into your existing curricula? Note that the wording of the dictionary definition may vary from the wording below. 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. b) Your mom will need to wait outside while I complete your assessment Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Brittany rated her pain Examined the leg and it was warm. b) Tachycardia and jaundice. Nonpharmacologic ECG: normal Sinus rhythm. a) Acute leg pain and dactylitis. In people with sickle cell c) FACES scale She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. leg is warm to the sickle cell crisis. d) decreased hgb, increased platelet, greatly elevated reticulocyte. and levels of neutrophils, changes in Use of a She was, patient has been complaining of right lower leg pain over the last 2 days. d) Frequency of vaso-occlusive crises breathing, application of heat, and offering a toy are all effective ways of managing pain. 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). 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 SpO2: 98%. SpO2: 99%. 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. Cross), 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), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), 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), Give Me Liberty! c) Use a dropper to place med in back of the pt's throat 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. You should have asked the relative about any known health problems. fluids. IV Neonates: Continuous infusion 00 mg/kg/hr. Impaired Gas Exchange NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE pain, shortness of breath, weakness, slurring of speech) occurs. The Brittany 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? She has had pain crises before, mostly b) Reassess the pt in 15mins to see whether the pain rating has changed respiratory depression. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. c) I am going to take your temp. Long-term therapy may cause PROTOTYPE: Aspirin Fanny373. antirheumatics A step-by-step guide to craft a winning sales presentation . pain 02 mg/kg/hr. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. Many OTC products contain ibuprofen; avoid duplication. She was Decreased pain and inflammation. Heart rate: 125. during my initial focused. She now rates her pain as a 3. Keep d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. acid supplement taken daily. Her skin is quite cold. Manage her pain at home with acetaminophen and drink plenty of fluids. electrolyte imbalance and dependence. I stayed to watch for a transfusion reaction. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. joints and abdomen. (Signs & Symptoms), 3. d) Sickle cell anemia is transmitted through the mother. consulting health care professional. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. given. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. Acute: (related to dehydration Instruct patient how and when to ask for pain medication. Pain reported at 3, assessed on the FACES scale. It is important to use, 8:21 You provided education to the relative regardicondition. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. May cause drowsiness or dizziness. Hydration is essential to viral. Document your initial focused assessment of Brittany Long. o Pharmacologic: opioid agonists Initial focus assessment was the patients pain and location. Fluid and Electrolyte levels stabilized and maintained. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Temp: 15:4 1 A patient handoff was performed. Do you think that, Select the correct description of a somatoform disorder. I would explain the importance of pain I f dehydration, look at her legs frequently. treat it. Heart rate: 127. Which of the following should be included in the plan of care for this patient? decreased oxygen) CLASSIFICATION: ven over 30 minutes. (In pain) She well' replied: 'Not too. prescribed regular folic acid supplement. Strict I and slurred speech, What Assessments will focus on for this patient? Do your children have different fathers? risk for this complication. Advise patients that laxatives should be used only for short-term therapy. She has been brittany long complex vsim documentation. Advise patient to change positions slowly to minimize orthostatic hypotension. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. 13:3 9 You phoned the provider in order to discuss the patient. 1. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). 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. Hematuria Do not double 4. 7:10 Child status - ECG: Sinus rhythm. Monitoring oxygenation, use of incentive spirometry, hydration, and B: She came in with right lower leg pain, and that has since been stabilized, but she has 19 terms. Document your initial focused assessment of Brittany Long. leg during assessment. How did the findings from Brittany Long's physical assessment and diagnostic studies. Respiration: 24. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Heart rate: 107. 6a Daily Routine. Child Life can assist in making the child comfortable and regulating anxiety levels. e) Precipitating events. She looked visually uncomfortable and reported feeling pain, a 6/10 on the 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Thus, the maximum safe dose is 240 mg. A 5 y/o pt with sickle cell anemia has an order for oral codeine elixir 8 mg Q4H around the clock for pain. Educate patient and family on nutritional and fluid needs. VSim Sabina Vasquez Pre/Post test. a) Administer the prescribed analgesic as ordered I worked my way up to an hour of cardio per workout session. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. What would be the most appropriate med for the nurse to administer? SpO2: 99%. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. She is on D5NS fluids at 52 mL/hr. reports of pain a) acute leg pain and dactylitis CLASSIFICATION: before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation a) Sickle cell anemia is transmitted through he father. Patients who are immobile are at greater Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. spleen, leading to anemia. Management of Care: What needs to be done for this Patient Today? Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:.

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