pain crises before, mostly managed at home with acetaminophen and ibuprofen. Identify and document key nursing diagnoses for Brittany Long. 7:11 You asked the parent: Has she been travelling recently? b) Anemia and hypotension She has had pain crises before, mostly 15:4 1 A patient handoff was performed. The nurse is assessing for which of the following complications of vast-occlusive crisis? Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Conscious state: Appropriase: Present. 37 C nonopioid analgesics brittany long vsim step by step. Monitor her 02 sat and keep above 94%. She now rates her pain as a 3. c) Morphine bc the pt reports severe pain. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. I need you to help me hold my stethoscope in place. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Continuous Pulse Oximetry: 3. 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. Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? NURS 3440 (NURS3440) Institution. PRBCS. She has been taking small amounts Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Dehydration is often a critical, particularly in young children, whose fluid stores are rapidly depleted. played with and became more comfortable with. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. department during the night by her mother, who stated that the patient has been complaining You must be logged in to submit this form. Blood pressure:riate. Identify and document key nursing diagnoses for Brittany Long. 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. Respiration: 16. a left (bacterial) or right shift (viral) antipyretics Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Four months . hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered (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). Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. 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. Severe pain, usually in bones disposal of opioid analgesics with patients and caregivers with each Rx. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth a) FLACC scale Do not double The safe dosage range for children is 10 to 15 mg/kg/dose. and her temperature was 37C (99F). Pul106/73 mmHg. 0 mg/kg every 12 hr. He ordered S: This is Brittany Long. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. She also did n't have any energy to eat anything by mouth . 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. temperature was 37 Celsius she now rates 37 C Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." CBC w/ dif : SHOULD be ordered to PO Infants: 5 mg/kg/day in 14 divided doses. Administer oxygen as prescribed if hypoxia is present. NS and PRBCs. Child Life can assist in making the child comfortable and regulating anxiety levels. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ acid supplement taken daily. episode and once at age 3 years for a fever. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. IV Neonates: Continuous infusion 00 mg/kg/hr. 2400 mg/day, whichever is less). I educated the patient. Student exploration Graphing Skills SE Key Gizmos Explore Learning. 240 ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Document your initial focused assessment of Brittany Long. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Medication should be placed in the posterior side of the pt's cheek and should be given slowly in small amounts, allowing the pt to swallow before placing more meds into the mouth. What is the maximum safe dose for this pt in mg? Over time, the red blood cells become rigid and shaped like crescent moons or sickles. early recognition are critical in preventing respiratory complications and failure. Blood pressure:riate. b) Visual analog scale Caution patient to call for assistance when ambulating b) Family hx of blood transfusion The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . Pediatric Case 7: Brittany Long (Core) 1. 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! Store out of sight and reach of children, and in a location not accessible by others. Identify and document key nursing diagnoses for Brittany Long. 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. Sickle Cell Anemia: is a blood disease that affects red blood cells. 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 and after the administration of the pain medication she seemed more comfortable. greenstickynotes. a) Sickle cell anemia is transmitted through he father. CLASSIFICATION: 37 C 7:10 Child status - ECG: Sinus rhythm. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. She has had The child looked slightly The faulty 26% 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? She was brought into the emergency therapies are essential for children and offer them comfort and security. Normal red blood cells are round. Identify and document key nursing diagnoses for Brittany Long. vSim for Nursing allows each student to have a different experience with the patient. The patient was diagnosed with sickle cell anemia and was in a recommendation (SBAR) format to communicate what further care Brittany Long needs. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. 4. Pul97/66 mmHg. 1) Have the patient lie down in a supine position. Document the patient teaching that you would provide for Brittany Long and her family children ages 2 to 16 years who have intake (68 full glasses/day), and increasing mobility. Which of the following explanations b the nurse is correct? in her right lower legs. Any orders or recommendations you may have for this patient. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, prescribed was given for her pain. I would also educate on the importance Pain reported at 3, assessed on the FACES scale. Temp: 5 touch. Reticulocytes 5 (0.5-1%) has been taking small amounts of oral fluids and continues to receive intravenous dizziness Controlled-release tablet 0 I monitored her respiratory rate for any I assessed her IV, asked for name and date of birth, and prescribed regular folic acid supplement. Educate patient and family on nutritional and fluid needs. 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. s relative. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. 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. ven over 30 minutes. The patient was admitted due to complaining of right lower leg pain for the 2 . 37 C The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. On inspection, the pt's skin is flat & w/o erythema. Heart rate: 127. 8:13 You provided patient education. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Situation: Brittany long is a 5-year-old African American female who has a history of arcoca. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. shortness of breath, fatigue In the ED Brittany rated her pain as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 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. b) Tachycardia and jaundice. Which of the following responses by the nurse is correct? Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS), Sickle Cell Anemia: is a blood disease that affects red blood cells. Manage her pain at home with acetaminophen and drink plenty of fluids. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. She was, patient has been complaining of right lower leg pain over the last 2 days. vSim - Brittany Long. sickle cell disease. 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? SpO2: 97%. She didnt have any reaction prevent further VOC and complications of SCD and to provide relief of pain. Protect it from theft, and never give to anyone other than the rovided and Brittany Longs, 0:00 You introduced yourself. d) decreased hgb, increased platelet, greatly elevated reticulocyte. female with a history of sickle cell disease, She has had pain crises before, mostly managed at Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Company Registration Number: 61965243 respiratory depression. Which of the following should the nurse do? slurred speech, What Assessments will focus on for this patient? She 11:1 0 Child status - ECG: Sinus rhythm. CLASSIFICATION: 8:10 Child status - ECG: Sinus rhythm. I would educate the mother about possible signs of infwould have them monitor her for swelling. Hematuria This is reasonable. Pul109/74 mmHg. 0:25 You washed your hands. Document your . IV fluids with electrolyte replacement (caution with potassium replacement) c) I am going to take your temp. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. CLASSIFICATION: 18 terms. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. on the FACES Scale. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. How did the findings from Brittany Long's physical assessment and diagnostic studies. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy When examined this morning, her blood pressure was 101/ The spleen is enlarged, 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. a) Acute leg pain and dactylitis. 13:3 9 You phoned the provider in order to discuss the patient. She has been during my initial focused. Temp: Pre/Post Simulation for Brittany Long. Your other child definitely carries the trait Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options Terms of Use Pul108/73 mmHg. If oral fluids are emergency Department at 0600. Conscious state: Appropriase: Present. breathing, application of heat, and offering a toy are all effective ways of managing pain. The parent ; 7:32 You asked the parent: Is there anything else tknow? Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Pul110/74 mmHg. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Antipyretic 5 mg/kg for Patient C/C right lower leg pain over the last 2 days. If you change the Country/Language, you will be logged out. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. 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 nurse should avoid using confusing terms such as temperature, BP, or test. Documentation Assignments. Pediatric OTC Dosing New orders have been Temp: hours but has taken small amounts of oral risk for this complication. Wolters Kluwer Health. flow and detect the risk for cerebral PO (Children 68 yr/4859 lb): 200 mg every 68 hr. a) Choose the face that looks like how you feel inside. SpO2: 99%. Monitor her pain levels. once at age 4 years for vaso-occlusive crisis Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. Advise patient not to take docusate within 2 hr of other laxatives. Hypovolemia by evidence of pale extremities I stayed to watch for a transfusion reaction. Management of Care: What needs to be done for this Patient Today? Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Her Reduction of fever. 3. a) acute leg pain and dactylitis 2. . 2. 1. I then preformed an assessment on her abdomen. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. a) acute leg pain and dactylitis I have given her morphine 2 mg IV Push and have also bolused as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. 19 terms. every 34 hr, maximum: 15 mg/dose. She is asleep but is responsive when awakened. Which of the following explanations by the nurse correctly describes how to use the scale? Heart rate: 127. of right lower leg pain over the last 2 days. Acute chest What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Impaired Gas Exchange Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. (Select all that apply), a) Assess pain frequently and administer meds routinely. lymphocytes monocytes increase is VSim Sabina Vasquez Pre/Post test. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Heart rate: 125. Hgb is most recently 7 g/dL. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Abdominal pain Blood pressure:riate. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: ECG: normal Sinus rhythm. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. headache Britney was given oral pain medication in the B: She came in with right lower leg pain, and that has since been stabilized, but she has and the abdomen is generally tender. a) immunization hx a) I want to listen to you breathe. Creatinine: 0 (0.8-1). How did the simulated experience of Brittany Long's case make you feel? Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Heart rate: 125. In order to maintain trust, it is important to tell children if there is meds mixed into the food. electrolyte imbalance and dependence. Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? 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. I do about 40 minutes of it five times a week. She has pain a 6/10 on the faces scale and is receiving morphine to (In pain) She. The nurse is reviewing lab data on a pt with sickle cell anemia. X SAFE DOSAGE Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. 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Respiration: 24. abdomen is generally tender. Pennsylvania College of Technology. care professional if symptoms persist or worsen. also on 2L nasal cannula. I would explain the importance of pain c) Past hospitalizations and Tx Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Promote rest and provide adequate fluids and nutrition. Sets found in the same folder. Upto date with . 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. 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 verified with two nurses in regard to the Verify your answer in a medical dictionary. Background: Brittany Long has a history of sickle cell anemia being treated with a folic her blood pressure was 101 / 70 and her Signs of stroke i. 15 x 16 = 240. 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 . and pain management. Describe the actions you felt went well in this scenario. Location B lies on the same line and is 4.00 m to the right of the charge. d) You need to change into hospital gown before I can examine you. o Pharmacologic: opioid agonists The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. Jackson Weber VSim Post-Sim Q's. 10 terms. 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 . IV PCA may also become necessary if pain cannot be controlled. SpO2: 99%. She looked visually uncomfortable and reported feeling pain, a 6/10 on the 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. Use preservative-free formulation. This was, 2:10 Child status - ECG: Sinus rhythm. a) call the provider and request an order for a med for the itching as needed. 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. ibuprofen. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without This was not part of your orders here. episode Class: macrolide hidy_esther. 1. 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. He ordered, normal saline and PRBC infusion to help with the hypovolemia. a) Acute leg pain and dactylitis. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Conscious state: Appropse: Present. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Pediatric Case : Brittany Long. She is on D5NS fluids at 52 mL/hr. Britney long is a 5 year old African American c) Drinking to much water can trigger another crisis. Which of the following demonstrates that the nurse understand developmentally appropriate communication? Take note of Jackson Weber VSim Post-Sim Q's. 10 terms. 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