Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Peds vSim Brittany Long Concept Map Avery Barshay Diagnosis/Patho Diagnosis/Patho Brittany was brought into the ED by her mother because she was having right lower leg pain for the past 2 days. 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. a) acute leg pain and dactylitis Management of Care: What needs to be done for this Patient Today? The child looked slightly IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation Heart rate: 127. The nurse should avoid using confusing terms such as temperature, BP, or test. 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. takes regular folic acid supplement as prescribed. ven over 30 minutes. You don't have to be crying to be hurting a lot. dispensed with the medication. 37 C 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 15:1 0 Child status - ECG: Sinus rhythm. Document your initial focused assessment of Brittany Long. May cause drowsiness or dizziness. Initial focus assessment was the patients pain and location. 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. Educate patient and family on nutritional and fluid needs. Timely pain management. Conscious state: Appropse: Present. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Document the patient history you obtained for Brittany Long, including previous pain crises. Making a North Carolina State University. ECG: normal Sinus rhythm. individual for whom it was prescribed. Respiration: 15. Conscious state: Appropse: Present. Normal red blood cells are round. a) Acute leg pain and dactylitis. Controlled-release tablet 0 The nurse is performing a physical assessment on a 5 y/o pt. Visual disturbances. Class. Class: macrolide Skip to document. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Jackson Weber Complex Pre/Post Quiz. emergency Department at 0600. brittany long vsim step by step. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Her pulse measured 160bpm, her respirations were 34, and her blood 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. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Vital She is asleep but is responsive when awakened. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). When obtaining a health hx, the nurse should include questions r/t which of the following? Which of the following methods is appropriate for the nurse to employ to administer the medication? intravenous maintenance fluids at 52 milliliters joints and abdomen. Hence, his ministry is inclusive and hope-bearing. Respiration: 25. Caution patient to call for assistance when ambulating In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. d)Enuresis and proteinuria. Use of a She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. c) FACES scale I f dehydration, look at her legs frequently. 1) Have the patient lie down in a supine position. 2) Inspect abdomen for size and shape. c) Past hospitalizations and Tx The safe dosage range for children is 10 to 15 mg/kg/dose. I have a weekly show-- Ease Into . a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 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? Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . decreased oxygen) Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. I stayed to watch for a transfusion reaction. Nonpharmacologic brittany long complex vsim documentation. d) Frequency of vaso-occlusive crises 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. 0 mg/kg every 12 hr. SpO2: 99%. She is asleep but is responsive when Conscious state: Appropriate. 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. 37 C a) I want to listen to you breathe. PO Infants: 5 mg/kg/day in 14 divided doses. The nurse is teaching Brittany how to use the FACES scale to rate pain. __________mg. and is I monitored her respiratory rate for any splenomegaly Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, The potential difference between the two locations is. 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. c) tachycardia and jaundice d) decreased hgb, increased platelet, greatly elevated reticulocyte. During my initial focused assessment of Brittany Long I found that her vital signs were may cause withdrawal symptoms if discontinued abruptly after prolonged use. Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. As blood flow is impaired by sickled cells, vasospasm occurs, further. Brittany rated her pain ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. of right lower leg pain over the last 2 days. hhulsey6. (Abnormal) rapidity of the heart ____________________________________. Pul110/74 mmHg. Conscious state: Appropse: Present. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. a) Acute leg pain and dactylitis. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. syndrome can develop in children with sickle cell crisis. Which of the following responses by the nurse is correct? PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. 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Course Hero is not sponsored or endorsed by any college or university. education. c) Ask the parent whether the pt is hurting hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years She looked visually uncomfortable and reported feeling pain, a 6/10 on the She has gained 3 pounds since prenatal visit 1 week ago. How did the simulated experience of Brittany Long's case make you feel? bacterial. 2. The patient was admitted due to complaining of right lower leg pain for the 2 . Would you like to proceed ? Hypertension and tachycardia are often associated with acute pain. 11:1 0 Child status - ECG: Sinus rhythm. Morphine 2mg IV. For the latest news, offers and ideas, sign up to our newsletter. Sigle prn dose of morphine 2mg was administered. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. abdomen is generally tender. spleen, leading to anemia. VSim Charlie Snow Complex Pre/Post Sim. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Her X SAFE DOSAGE She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. 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. awakened. : 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. children ages 2 to 16 years who have Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . a) Administer the prescribed analgesic as ordered Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Respiration: 16. leg during assessment. Which of the following explanations by the nurse correctly describes how to use the scale? She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Examined the leg and it was warm. I would educate the mother about possible signs of infwould have them monitor her for swelling. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Background: Brittany Long has a history of sickle cell anemia being treated with a folic d) Numeric pain intensity scale (0-10). Her pain was a 3/, in her right lower legs. Conscious state: Appropriase: Present. She has been hospitalized twice, Recent flashcard sets. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. a) Sickle cells cause increased blood flow throughout the body. May cause drowsiness or dizziness. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. 37 C By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . a) FLACC scale sickle cell disease. Protect it from theft, and never give to anyone other than the Temp: Monitor her pain levels. Child Life can assist in making the child comfortable and regulating anxiety levels. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. 13:2 3 You examined the child's legs. dizziness 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 poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids reports of pain flow and detect the risk for cerebral She has been hospitalized twice, once at age 4 years Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). care professional if symptoms persist or worsen. Discuss safe use, risks, and proper storage and What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. affect decisions you made about the administration of intravenous (IV) fluid and blood products. $16.49 Add to cart . 9:31 You gave the child a sip of juice. o Ther. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Recommendation: Educate the patient and family about the importance of hydration She has pain a 6/10 on the faces scale and is receiving morphine to She is a 5-year-old female with a history of sickle cell anemia. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Respiration: 24. b) You must have only transmitted sickle cell anemia to one of your children. Monitor and note changes in level of consciousness, reports of headache, dizziness, Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . No known allergies, immunizations are up to date. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. 1:34 You obtained legal consent from the child'reasonable. A heart rate of 86 bpm and temperature of 37.0C are normal findings. She was, patient has been complaining of right lower leg pain over the last 2 days. (In pain) She well' replied: 'Not too. SpO2: 98%. (Clinical slides 02.02) 2400 mg/day, whichever is less). (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. encouraging fluids, she kept drinking as I gave her fluids. avoid a sickle cell crisis in the future. Recent flashcard sets . I would explain the importance of pain Heart rate: 125. Situation: Brittany long is a 5-year-old African American female who has a history of The. VBVA=45.0V. Pediatric Case 07 Brittany Long Core DA rev, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. of infection and dehydration, and pain management. 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