9:31 You gave the child a sip of juice. and educated the mother about signs of a reaction. Conscious state: Appropse: Present. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE jaundice ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. Brittany was given oral pain medication in the emergency department at 6:00 AM. VSim Brittany Long Pre/Post test Flashcards | Quizlet Decreased pain and inflammation. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). The increased blood flow through the blood vessels causes tour child to have severe pain c) Past hospitalizations and Tx (Clinical slides 02.02) The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Document the patient teaching that you would provide for Brittany Long and her family I Temp: 37.3. Temp: bacterial. occlusive crisis. d) You need to change into hospital gown before I can examine you. and levels of neutrophils, changes in To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Ninon_sassy. has been complaining of right lower leg pain Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . normal saline and PRBC infusion to help with the hypovolemia. brittany long vsim step by step. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 26% PO (Children <3 yr): 1040 mg in 14 divided doses. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. department during the night by her mother, who stated that the patient has been complaining a) Acute leg pain and dactylitis. by her mother, who stated that the patient Her skin is quite cold. b) Anemia and hypotension Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. I do about 40 minutes of it five times a week. spleen, leading to anemia. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. 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Peds v Sim Brittany Long by Avery Barshay - Prezi She was brought into the ED during the night 10:1 0 Child status - ECG: Sinus rhythm. Jackson Weber VSim Post-Sim Q's. 10 terms. times/day to 3 times/wk. viral. Referring to your feedback log, document the nursing care you provided and Brittany Deep. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. The padon&apos;t think so.&apos; rent replied: &apos;No. Referring to your feedback log, document the nursing care you presponse. She has not had an appetite in the last 24 S: This is Brittany Long. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. : 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) Enuresis and proteinuria. 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. Respiration: 16. : 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. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Which of the following responses by the nurse is correct? VSim Brittany Long Pre/Post test. 2:49 You identified the child. She has been o Pharm. Acute chest Pul110/74 mmHg. CBC due Q 4 hours. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Peer-to-Peer Skills Development in Nursing, Simulation Education Solutions for Nursing, One Million Lives - Our Shared Goal for 2030, Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis, Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration, Charlie Snow (Core) - Mild Allergic Reaction, Jackson Weber (Core) - Generalized Tonic-Clonic Seizures, Jackson Weber (Complex) - Status Epilepticus, Sabina Vasquez (Core) - Mild Intermittent Asthma, Sabina Vasquez (Complex) - Pneumonia Leading to Respiratory Distress in a Child with Known Asthma, Safety Measures Practice safe procedures. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? __________mg. 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). 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 reports of pain Signs of stroke i. What is the maximum safe dose for this pt in mg? SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Your name, posi t on (RN), unit you are working on SITUATION The patient is Brittany Long, a 5-year-old African American female with a history of sickle cell disease whom was diagnosed at 6 months old. prescribed regular folic acid supplement. c) Ask the parent whether the pt is hurting Heart rate: 107. Heart rate: 126. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Her skin is quite cold. Normal bowel habits are variable and may vary from 3 Pediatric Case 7: Brittany Long (Core) Documentation Assignments. She has had pain crises before, mostly administer blood products, usually packed RBCS an exchange transfusions per facility protocol. anemia or sickle cell trait Pediatric OTC Dosing Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Morphine 2mg IV given as VSim Sabina Vasquez Pre/Post test. 13:3 9 You phoned the provider in order to discuss the patient. 37 C nonopioid analgesics School Herzing University; Course Title PN 124; Uploaded By hana254830. respiratory depression. b) Family hx of blood transfusion Pediatric Case 07 Brittany Long Core DA rev - StuDocu What is the magnitude and sign of the charge? Document your initial focused assessment of Brittany Long. Conscious state: Appropse: Present. Respiration: 25. Sickled RBCs, become rigid and cresent shaped. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. female with a history of sickle cell disease, 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 (In pain) She. decreased oxygen) Look for signs oection such as fever and shortness of breath. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Recent flashcard sets. flow and detect the risk for cerebral She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Pul109/74 mmHg. Administer oxygen as prescribed if hypoxia is present. Pul108/73 mmHg. How did the simulated experience of Brittany Long's case make you feel? management so it does not turn into a crisis. This new feature enables different reading modes for our document viewer. CLASSIFICATION: Nonpharmacologic Family members should be encourage to stay at the, bedside to offer comfort and help to minimize the tremors of hospitalization, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, Sickle cell anemia is an inherited, autosomal recessive disorder characterized by an abnormal form, of hemoglobin in the RBC. Which of the following should be included in the plan of care for this patient? Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Are you considering implementing vSim for Nursing into your existing curricula? . Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device dispensed with the medication. She has been taking small amounts 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. I then did a pressure was low. The right lowertouch. Document your handoff report in the situation-background-assessment- Do not stop taking without discussing with health care professional; Temp: d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. I need you to help me hold my stethoscope in place. 1:34 You obtained legal consent from the child&apos;reasonable. I have a weekly show-- Ease Into . acid supplement taken daily. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu It is important to use, 8:21 You provided education to the relative regardicondition. Heart rate: 125. 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. We have noticed you are logged in to ${country}. 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. Observe for manifestations Promote rest and provide adequate fluids and nutrition. 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I Conscious state: Appropse: Present. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. The pt is lying quietly in bed watching TV. Temp: 5 touch. 37 C Respiration: 25. Timely pain management. Pul109/74 mmHg. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. 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 . The spleen is enlarged, black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest c) I am going to take your temp. slurred speech, What Assessments will focus on for this patient? a) Acute leg pain and dactylitis. She now rates her pain as a 3. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Maintain adequate fluid intake and monitor urine output. 37 C Blood pressure:riate. Monitor her 02 sat and keep above 94%. 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. What are you on alert for with this patient? Diagnosed with sickle cell disease at age 6 months. Transcranial Doppler : Could be awakened. Monitoring oxygenation, use of incentive spirometry, hydration, and Heart rate: 128. d) Frequency of vaso-occlusive crises 18 terms. Child Life can assist in making the child comfortable and regulating anxiety levels. Heart rate: 127. s relative. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . 37 C Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. home with acetaminophen and ibuprofen. Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. Pul97/66 mmHg. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS - Stuvia Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? She has 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. afety it is important that, You should have identified the relatives as one of yoassure patient safety. 13 terms. 8:13 You provided patient education. SpO2: 97%. Fanny373. determine anemia state & if there is pain 02 mg/kg/hr. takes regular folic acid supplement as prescribed. hepatomegaly Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Conscious state: Appropse: Present. She looked visually uncomfortable and reported feeling pain, a 6/10 on the M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg The potential difference between the two locations is. b) Visual analog scale o Recommended dosage is 2060 mg in 14 divided doses Pul110/74 mmHg. 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. 19 terms. Conscious state: Appropse: Present. Respiration: 15. a) acute leg pain and dactylitis 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. o Pharm. Temp: ood or had a reaction to a. Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd Monitor and note changes in level of consciousness, reports of headache, dizziness, intake (68 full glasses/day), and increasing mobility. She has pain a 6/10 on the faces scale and is receiving morphine to The nurse is teaching Brittany how to use the FACES scale to rate pain. NS and PRBCs. and is 2400 mg/day, whichever is less). dispensed with the medication. a) Choose the face that looks like how you feel inside. Wolters Kluwer Health. PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Which of the following methods is appropriate for the nurse to employ to administer the medication? Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. 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. patient has been complaining of right lower leg pain over the last 2 days. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale.

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