Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. You don't have to be crying to be hurting a lot. fluids. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Stabilizing fluid levels to assist in relieving pain. 3. Document your initial focused assessment of Brittany Long. (In pain) She well&apos; replied: &apos;Not too. (In pain) She. ven over 30 minutes. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. over the last 2 days. IV Neonates: Continuous infusion 00 mg/kg/hr. Heart rate: 125. 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. 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. Advise patient that morphine is a drug with known abuse potential. Circulating sickle cells are hemolysized by the. Creatinine: 0 (0.8-1). 8:10 Child status - ECG: Sinus rhythm. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Cross), 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), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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You should have asked the relative about any known health problems. She has had pain crises before, mostly Heart rate: 127. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest PO (Children 11 yr/7295 lb): 300 mg every 68 hr. A. Somatization disorder - manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical, Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? Vaso-occlusive pain crisis from sickle cell anemia Pul109/74 mmHg. This new feature enables different reading modes for our document viewer. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. Patient C/C right lower leg pain over the last 2 days. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. Do not double 37 C 7:37 You asked the parent: Is there anything else tknow? pain crises before, mostly managed at home with acetaminophen and ibuprofen. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Look for signs oection such as fever and shortness of breath. Which of the following explanations b the nurse is correct? ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Document your . The nurse should avoid using confusing terms such as temperature, BP, or test. Promote rest to decrease oxygen consumption. PROTOTYPE: Morphine. a) Administer the prescribed analgesic as ordered Class. Brittany 15 x 16 = 240. Heart rate: 127. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. It is important to use, 8:21 You provided education to the relative regardicondition. 37 C I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. Temp: PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. acid supplement taken daily. 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Course Hero is not sponsored or endorsed by any college or university. Temp: mg Brittany Long was diagnosed with sickle cell disease at 6 months old. 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. Voc Latin page 24. 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. and her mother about why those were being given. She has been hospitalized twice, He ordered 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 Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Over time, the referral to the pain team may also be helpful in SCD crises management. of hydration with patients who have sickle cell anemia. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). We have noticed you are logged in to ${country}. To maintain patient syou quickly identify the child. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Describe the actions you felt went well in this scenario. Initial focus assessment was the patients pain and location. tired. o Therapeutic: opioid analgesics Student exploration Graphing Skills SE Key Gizmos Explore Learning. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Document your initial focused assessment of Brittany Long. 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? Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." I would also educate on the importance critical, particularly in young children, whose fluid stores are rapidly depleted. b) Hide med in applesauce or ice cream and have the parent feed the pt (SBAR) format to communicate what further care Brittany Long needs. received a unity of PRBCS. Examined the leg and it was warm. Respiration: 24. 2:49 You identified the child. developmentally appropriate pain scale and assessment of pain behaviors are essential in Hence, his ministry is inclusive and hope-bearing. SAFE DOSE OR DOSE RANGE, SAFE ROUTE The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. Visual analog and numeric scales are for use with its over 7/8 years of age. Use of a Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Visual disturbances. Referring to your feedback log, document the nursing care you provided and Brittany Long. Use preservative-free formulation. Ineffective Tissue Perfusion Vital signs q4h Continuous Pulse Oximetry: Monitor O2 saturation levels Labs; daily complete blood count and basic metabolic panel, Blood analysis (notable): Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5 (0.5-1.5%) Electrolytes Creatinine: 0.4 (0.8-1.4). b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness The nurse is performing a physical assessment on a 5 y/o pt. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. New orders have been. She has had Over time, the red blood cells become rigid and shaped like crescent moons or sickles. dizziness 18 terms. Sickle Cell Anemia: is a blood disease that affects red blood cells. Conscious state: Appropriase: Present. 37 C 1:34 You obtained legal consent from the child&apos;reasonable. line infusion rate to 52. I educated the patient. prescribed regular folic acid supplement. 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. Which of the following would be the best response by the nurse? Take note of Do you think that, Select the correct description of a somatoform disorder. 19 terms. 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. encouraged PO fluids and she drank some. 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. Initial focus assessment was the patients pain and location. Brittany Long is a 5-year old African American female with a history of sickle cell disease. IF you have four children, one or 25% will have sickle cell anemia. occlusive crisis. Identify and document key nursing diagnoses for Brittany Long. 18 terms. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? and her temperature was 37C (99F). I then did a A step-by-step guide to craft a winning sales presentation . Pul97/66 mmHg. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Situation: Brittany long is a 5-year-old African American female who has a history of Bp is trending low, she has normal saline running at 320 ml/hr and has recently a. Xist 20 terms. Educate patient and family on nutritional and fluid needs. has been taking small amounts of oral fluids and continues to receive intravenous You must be logged in to submit this form. 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. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. 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? Heart rate: 126. used to assess Intercranial vascular Place the steps of an abdominal assessment in order. Her pain was a 3/5 on FACES scale VS can be monitored and reported by the UAP. 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. Advise patients that laxatives should be used only for short-term therapy. headache The spleen is enlarged, Jackson Weber VSim Post-Sim Q's. 10 terms. Temp: c) Morphine bc the pt reports severe pain. 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. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 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. c) FACES scale May cause drowsiness or dizziness. Document your handoff report in the situation-background-assessment- before discharge. Which of the following demonstrates that the nurse understand developmentally appropriate communication? Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Which of the following should be included in the plan of care for this patient? Sets found in the same folder. Normal red blood cells are round. This is correcevery opportunity to provide patient education. 19 terms. Assessment for signs and symptoms of dehydration is Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Brittany rated her pain Instruct patient to take medication as directed. Acute pain R/T sickle cell disease AEB vaso-occlusive crisis in right leg: The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. brittany long complex vsim documentation. 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. Her To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: arcoca . Take missed doses as soon as remembered but not if almost time for next dose. She has not had an appetite in the last 24 education. A heart rate of 86 bpm and temperature of 37.0C are normal findings. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family a) Place med in an oral syringe and allow the pt to squirt into his or her mouth I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. normal saline and PRBC infusion to help with the hypovolemia. Pre/Post Simulation for Brittany Long. IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or I called her provider to see what else I should do. PDA Closure pallor, pale mucous membranes M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Pul110/74 mmHg. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Pediatric OTC Dosing The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. Pulse: Present. 19 terms. Pul108/73 mmHg. 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. Her skin is quite cold. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Blood pressure:te. 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. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. b) Family hx of blood transfusion Conscious state: Appropse: Present. The parent ; 7:32 You asked the parent: Is there anything else tknow? Observe for manifestations 37 C B: She came in with right lower leg pain, and that has since been stabilized, but she has She has pain a 6/10 on the faces scale and is receiving morphine to intravenous maintenance fluids at 52 milliliters doses. during my initial focused. Blood pressure:riate. 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What would be the most appropriate med for the nurse to administer? 11:1 0 Child status - ECG: Sinus rhythm. nonsteroidal anti inflammatory agents 14:1 0 Child status - ECG: Sinus rhythm. determine anemia state & if there is Recent flashcard sets . Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. PO (Children 36 yr): 2060 mg in 14 divided doses. Pulmonary edema. Heart rate: 127. Respiration: 24. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. sickle cell crisis. 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, NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Decreased pain and inflammation. I worked my way up to an hour of cardio per workout session. This is reasonable. d) Numeric pain intensity scale (0-10). On inspection, the pt's skin is flat & w/o erythema. Which of the following should the nurse do? Brittany was given oral pain medication in the emergency department at 6:00 AM. VSim Charlie Snow Complex Pre/Post Sim. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. ibuprofen. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . PO (Children 612 yr): 40150 mg in 14 divided doses. Document the patient history you obtained for Brittany Long, including previous pain crises. She is a 5-year-old female with a history of sickle cell anemia. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. brought into the emergency department during the night by her mother, who stated that the I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Class: macrolide unstable. scale and did not want anyone to touch her breakthrough pain. Britney was given oral pain medication in the SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 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 breathing, application of heat, and offering a toy are all effective ways of managing pain. Conscious state: Appropse: Present. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. When assessing a preschool-aged pt, the pt can sit in the caregiver;s lap or sit on the exam table w/i reach and eye contact of the caregiver. Heart rate: 126. in her right lower legs. 7:03 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. When examined this morning, her blood pressure was 101/ Temp: 37.3. hands and feet cool to touch. consulting health care professional. red blood cells become rigid and shaped like crescent moons or sickles. abdomen is generally tender. a) I want to listen to you breathe. 37 C, 6:13 You asked the child if anything made the pain breplied: &apos;No&apos; etter. bacterial. Tolerance is not addiction. splenomegaly : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. The nursing care for Brittany Long began with obtaining a set of vitals.