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Dehydration is often a Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. individual for whom it was prescribed. I A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Abdominal pain Recent flashcard sets . maintenance fluids at 52 mL/hr. She rates her pain as a 5/5 on the FACES scale. 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: Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis. and BP now Conscious state: Appropse: Present. (In pain) She. Vaso-occlusive pain crisis from sickle cell anemia SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). Her pain was a 3/5 on FACES scale For the latest news, offers and ideas, sign up to our newsletter. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). 37 C Promote rest and provide adequate fluids and nutrition. Sickle Cell Anemia: is a blood disease that affects red blood cells. Instruct patient to take medication as directed. 37 C pain, shortness of breath, weakness, slurring of speech) occurs. Administer oxygen as prescribed if hypoxia is present. PROTOTYPE: Aspirin for a fever. Advise patient that morphine is a drug with known abuse potential. 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 M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Hence, his ministry is inclusive and hope-bearing. and educated the mother about signs of a reaction. Are you considering implementing vSim for Nursing into your existing curricula? shortness of breath, fatigue PRBCS. New orders have been. 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. prescribed regular folic acid supplement. Manage her pain at home with acetaminophen and drink plenty of fluids. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. The right lowertouch. (SBAR) format to communicate what further care Brittany Long needs. Conscious state: Appropse: Present. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). How did the simulated experience of Brittany Long's case make you feel? PURPOSE FOR TAKING THIS MEDICATION, Treatment of: You must be logged in to submit this form. c) Ask the parent whether the pt is hurting 37 C Identify and document key nursing diagnoses for Brittany Long. normal saline and PRBC infusion to help with the hypovolemia. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. vSim - Brittany Long. Ineffective Tissue Perfusion greenstickynotes. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. 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. also on 2L nasal cannula. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. 1:34 You obtained legal consent from the child'reasonable. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Monitor and note changes in level of consciousness, reports of headache, dizziness, a) Choose the face that looks like how you feel inside. This was, 2:10 Child status - ECG: Sinus rhythm. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids A. - fibers, The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life.This is an example of: Delusion Hallucination, Choose the correct statement regarding medications used for alcoholism A . I would also educate on the importance Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . She now rates her pain as a 3. The increased blood flow through the blood vessels causes tour child to have severe pain Reticulocytes 5 (0.5-1%) Initial focus assessment was the patients pain and location. Blood pressure:riate. Pain level controlled and maintained, avoiding. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Describe the actions you felt went well in this scenario. 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. 37 C PO (Children 68 yr/4859 lb): 200 mg every 68 hr. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. a) Acute leg pain and dactylitis. I/O can be calculated by UAP. Temp: 2. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. SpO2: 98%. Jackson Weber Complex Pre/Post Quiz. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. VSim Charlie Snow Complex Pre/Post Sim. a) Acute leg pain and dactylitis. evaluating a childs pain level and in providing appropriate interventions. 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. Which of the following responses by the nurse is correct? a) I want to listen to you breathe. Identify and document key nursing diagnoses for Brittany Long. She also didn't have any energy to eat anything by mouth. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. 13:3 9 You phoned the provider in order to discuss the patient. I The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. Conscious state: Appropse: Present. She has had pain crises before, mostly managed at Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. I monitored her respiratory rate for any, respiratory depression. Any orders or recommendations you may have 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. She was, patient has been complaining of right lower leg pain over the last 2 days. d)Enuresis and proteinuria. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Advise patients that laxatives should be used only for short-term therapy. NURS 3440 (NURS3440) Institution. 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). Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. regular heart sounds without murmurs. 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 If you change the Country/Language, you will be logged out. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. SpO2: 99%. Use preservative-free formulation. d) Anemia and hypotension. Neutrophils and bans are episode Pul98/67 mmHg. She has had episode and once at age 3 years for a fever. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Tolerance is not addiction. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. I educated the pati, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Give Me Liberty! Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Sets found in the same folder. The child looked slightly slurred speech, What Assessments will focus on for this patient? She was brought into the ED during the night A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. abdomen is generally tender. 20 terms. Children should never be force to change into a gown. o Recommended dosage is 2060 mg in 14 divided doses Document your handoff report in the situation-background-assessment- 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. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Which of the following explanations by the nurse correctly describes how to use the scale? Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Blood pressure:riate. Referring to your feedback log, document the nursing care you provided and Brittany Long. NS and PRBCs. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 9:10 Child status - ECG: Sinus rhythm. before discharge. Respiration: 24. ibuprofen. PO Infants: 5 mg/kg/day in 14 divided doses. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC.