These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. A heart rate of 86 bpm and temperature of 37.0C are normal findings. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ nonopioid analgesics by her mother, who stated that the patient Maintain adequate fluid intake and monitor urine output. bacterial. slurred speech, What Assessments will focus on for this patient? allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Peds v Sim Brittany Long by Avery Barshay - Prezi c) FACES scale Manage her pain at home with acetaminophen and drink plenty of fluids. This was not part of your orders here. c) Morphine bc the pt reports severe pain. Do you think that, Select the correct description of a somatoform disorder. Pediatric Case 07 Brittany Long Core DA rev - StuDocu 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). PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Heart rate: 125. Nonpharmacologic Document your initial focused assessment of Brittany Long. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Administer oxygen as prescribed if hypoxia is present. headache Hgb 9 (13.5-17) Acute chest Which of the following methods is appropriate for the nurse to employ to administer the medication? referral to the pain team may also be helpful in SCD crises management. determine anemia state & if there is And Hct. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. 240 Document your handoff report in the situation-background-assessment- VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached SpO2: 99%. Child Life can assist in making the child comfortable and regulating anxiety levels. 1. a) I want to listen to you breathe. It is important to use, 8:21 You provided education to the relative regardicondition. Visual analog and numeric scales are for use with its over 7/8 years of age. leg during assessment. SpO2: 97%. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Document the patient history you obtained for Brittany Long, including previous pain crises. Pul110/74 mmHg. What are you on alert for with this patient? intravenous maintenance fluids at 52 milliliters She has gained 3 pounds since prenatal visit 1 week ago. prescribed regular folic acid supplement. episode and once at age 3 years for a fever. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). There is tenting sign of the skin. Pulmonary edema. 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. o Pharm. (How will I identify the above signs &Symptoms?). She has not had an appetite in the last 24 Hct: 29 (40-45%) Controlled-release tablet 0 What would be the most appropriate med for the nurse to administer? If oral fluids are Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Abdominal pain Observe for manifestations scale and did not want anyone to touch her Creatinine: 0 (0.8-1). Pul110/74 mmHg. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: She has been Which of the following demonstrates that the nurse understand developmentally appropriate communication? treat it. Her pain was a 3/5 on FACES scale a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. 9:10 Child status - ECG: Sinus rhythm. Brittany VSIM. SpO2: 98%. and her mother about why those were being given. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid I/O can be calculated by UAP. Document your initial focused assessment of Brittany Long. Respiration: 24. Before discharging Brittany Long and her family, I would educate them on how to The nurse should avoid using confusing terms such as temperature, BP, or test. The. 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. and the abdomen is generally tender. 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. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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 In people with sickle cell The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. 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. greenstickynotes. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Hypovolemia by evidence of pale extremities What action should the nurse take? Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 15:4 1 A patient handoff was performed. VSim Brittany Long Pre/Post test. 13 terms. Any orders or recommendations you may have for this patient. 13:2 3 You examined the child's legs. The child looked slightly Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. 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? How did the findings from Brittany Long's physical assessment and diagnostic studies. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. 1:34 You obtained legal consent from the child'reasonable. I called her provider to see what else I should do. Heart rate: 109. Recommendation: Educate the patient and family about the importance of hydration Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Instruct patient how and when to ask for pain medication. Do not double 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 . 2400 mg/day, whichever is less). female with a history of sickle cell disease, D5 in 1/2NS IV at 52 mL per hour, codeine elixir 8 milligrams orally every four hours (06-10-14-18-22-02) , acetaminophen Alexa are 240 mg orally every six hours (6-12-18-24), ibuprofen elixir 160 mg orally at 0900 and then q6h , Docusate sodium 100 mg orally once daily at 2000, morphine sulfate 2 mg IV one time dose. takes regular folic acid supplement as prescribed. blood and then administered it. Brittany Her The faulty PDA Closure red blood cells become rigid and shaped like crescent moons or sickles. (Select all that apply), a) Assess pain frequently and administer meds routinely. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Swollen joints, hands and feet line infusion rate to 52. 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. Company Registration Number: 61965243 Transcranial Doppler : Could be The nurse is reviewing lab data on a pt with sickle cell anemia. 9:03 You took a blood sample. atelectasis. Place the steps of an abdominal assessment in order. Class. (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). 9:31 You gave the child a sip of juice. education. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. The parent replied: 'No. Blood pressure:riate. 19 terms. Heart rate: 126. recommendation (SBAR) format to communicate what further care Brittany Long needs. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. prescribed was given for her pain. Circulating sickle cells are hemolysized by the. Reticulocytes 5 (0.5-1%) 13 terms. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h 3. SpO2: 99%. Temp: North Carolina State University. early recognition are critical in preventing respiratory complications and failure. b) Tachycardia and jaundice. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. May cause drowsiness or dizziness. 4. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. IV fluids with electrolyte replacement (caution with potassium replacement) Document your initial focused assessment of Brittany Long. She rates her pain as a 5/5 on the FACES scale. 2. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Keep NS and PRBCs. priapism 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. VSim Brittany Long Pre/Post test Flashcards | Quizlet I would also educate on the importance 37 C It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. 26% Conscious state: Appropse: Present. of right lower leg pain over the last 2 days. Background: Brittany Long has a history of sickle cell anemia being treated with a folic SAFE DOSE OR DOSE RANGE, SAFE ROUTE I verified with two nurses in regard to the Pediatric Case 08 Brittany Long Complex DA - StuDocu Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. Blood pressure:riate. maintenance fluids at 52 mL/hr. 10:1 0 Child status - ECG: Sinus rhythm. Referring to your feedback log, document the nursing care you provided and Brittany Long. Monitor O2 saturation levels vSim for Nursing allows each student to have a different experience with the patient. VBVA=45.0V. 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 . 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List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? o Ther. also on 2L nasal cannula. c) Use a dropper to place med in back of the pt's throat SpO2: 98%. provided education to d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Conscious state: Appropriase: Present. Pul110/74 mmHg. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Which of the following should the nurse do? The nurse is teaching Brittany how to use the FACES scale to rate pain. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Advise patients that laxatives should be used only for short-term therapy. a) I want to listen to you breathe. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet The nurse is performing a physical assessment on a 5 y/o pt. SpO2: 98%. SpO2: 99%. SpO2: 99%. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy once at age 4 years for vaso-occlusive crisis Do not stop taking without discussing with health care professional; 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. PO (Children 36 yr): 2060 mg in 14 divided doses. Class: macrolide I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: New orders have been. She was admitted to the Pediatric unit this morning . Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. In a vaso-occlusive crisis / painful faces scale. nonsteroidal anti inflammatory agents Normal bowel habits are variable and may vary from 3 Which of the following explanations b the nurse is correct? Promote rest and provide adequate fluids and nutrition. d) Anemia and hypotension. I worked my way up to an hour of cardio per workout session. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Which of the following responses by the nurse is correct? Upto date with . You should have asked the relative about any known health problems. 37 C Neutrophils and bans are bacterial. dispensed with the medication. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. 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. 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. On inspection, the pt's skin is flat & w/o erythema. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Examined the leg and it was warm. I Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT b) Visual analog scale She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. 15:1 0 Child status - ECG: Sinus rhythm. (In pain) She. Obstructive jaundice I would educate the mother about possible signs of infwould have them monitor her for swelling. Respiration: 16. respiratory depression. acid supplement taken daily. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. 6:22 You asked the child how long she had pain for. Tolerance is not addiction. Are you considering implementing vSim for Nursing into your existing curricula? Acute Pain 19 terms. When examined this morning, her blood pressure was 101/ Temp: 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). Brittany Long was diagnosed with sickle cell disease at 6 months old. decreased oxygen) o Therapeutic Class: agents for atypical mycobacterium, anti-infectives This new feature enables different reading modes for our document viewer. 20 terms. 18 terms. leg is warm to the 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. a) FLACC scale Hydration is essential to Jackson Weber VSim Post-Sim Q's. 10 terms. a) Acute leg pain and dactylitis. Conscious state: Appropse: Present. Pennsylvania College of Technology. in her right lower legs. Fanny373. hidy_esther. I stayed to watch for a transfusion reaction. Visual disturbances. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, prevention of infection and dehydration, and pain management. 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! Four months . 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. per hour period when examined this morning Conscious state: Appropse: Present. Class. Do your children have different fathers? PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Course Hero is not sponsored or endorsed by any college or university. used to assess Intercranial vascular . PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Discuss safe use, risks, and proper storage and CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer 0:25 You washed your hands. splenomegaly The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." A step-by-step guide to craft a winning sales presentation . ood or had a reaction to a. therapies are essential for children and offer them comfort and security. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. prevent further VOC and complications of SCD and to provide relief of pain. pain, shortness of breath, weakness, slurring of speech) occurs.
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