. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. A heart rate of 86 bpm and temperature of 37.0C are normal findings. o Pharm. This was, 2:10 Child status - ECG: Sinus rhythm. Reticulocytes 5 (0.5-1%) 4. If oral fluids are SpO2: 99%. Conscious state: Appropse: Present. : 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) FACES scale __________mg. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. (In pain) She well' replied: 'Not too. Respiration: 24. Blood pressure:riate. Heart rate: 126. 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. Find all solutions of the following equation. 0 mg/kg every 12 hr. PRBCS. Neutrophils and bans are bacterial. a) Acute leg pain and dactylitis. Respiration: 24. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. a) I want to listen to you breathe. c) Enuresis and proteinuria. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. has been taking small amounts of oral fluids and continues to receive intravenous Respiration: 24. Britney rated her pain as a 5 on the faces I administered more fluids and List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Dehydration is often a 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. 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CLASSIFICATION: Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu closely monitor laboratory results reporting any notable , out of range levels , NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE, MEDICATION: Morphine sulfate 2 mg IV (o mg/kg/dose) X 1 dispensed with the medication. d) Numeric pain intensity scale (0-10). nonopioid analgesics Pre/Post Simulation for Brittany Long Flashcards | Quizlet (SBAR) format to communicate what further care Brittany Long needs. Fluid and Electrolyte levels stabilized and maintained. Monitor and note changes in level of consciousness, reports of headache, dizziness, 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. 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. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. VSim Brittany Long Pre/Post test. encouraging fluids, she kept drinking as I gave her fluids. episode and once at age 3 years for a fever. Respiration: 25. She VSim Brittany Long Pre/Post test Flashcards | Quizlet Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Her pain was a 3/5 on FACES scale 6a Daily Routine. regular heart sounds without murmurs. PO Infants: 5 mg/kg/day in 14 divided doses. Identify and document key nursing diagnoses for Brittany Long. From vSim for Nursing | Pediatric. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). of infection and dehydration, and pain management. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives red blood cells become rigid and shaped like crescent moons or sickles. I f dehydration, look at her legs frequently. respiratory depression. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Disulfiram: NMDA receptor antagonist & GABAA agonist B . c) Drinking to much water can trigger another crisis. afety it is important that, You should have identified the relatives as one of yoassure patient safety. vSim for Nursing Pediatric | Laerdal Medical hepatomegaly Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. In a vaso-occlusive crisis / painful Recent flashcard sets . Brittany Long is a 5-year-old African American female with a history of sickle cell disease, The right lowertouch. 13:3 9 You phoned the provider in order to discuss the patient. Documentation Assignments. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Instruct patient how and when to ask for pain medication. SpO2: 99%. 240 The parent, 3:10 Child status - ECG: Sinus rhythm. Swollen joints, hands and feet pain assessment and asked her if she would like any medication for her pain. Temp: Pul106/72 mmHg. Brittany was given oral pain medication in the emergency department at 6:00 AM. rovided and Brittany Longs, 0:00 You introduced yourself. during my initial focused. May cause drowsiness or dizziness. 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Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Vital Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Student exploration Graphing Skills SE Key Gizmos Explore Learning. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. I monitored her respiratory rate for any Over time, the red blood cells become rigid and shaped like crescent moons or sickles. 7:37 You asked the parent: Is there anything else tknow? Antipyretic 5 mg/kg for home with acetaminophen and ibuprofen. 1. takes regular folic acid supplement as prescribed. 19 terms. avoid a sickle cell crisis in the future. NS and PRBCs. and her mother about why those were being given. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? PATIENT EDUCATION WHILE TAKING THIS MEDICATION Conscious state: Appropse: Present. Brittany VSIM. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Reduction of fever. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. She now rates her pain as a 3. Take note of of right lower leg pain over the last 2 days. X SAFE DOSAGE Pulmonary edema. 3. He ordered d) Sickle cell anemia is transmitted through the mother. vSim for Nursing allows each student to have a different experience with the patient. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. played with and became more comfortable with. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. 9:03 You took a blood sample. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). before discharge. I called her provider to see what else I should do. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. c) tachycardia and jaundice doses. Jackson Weber VSim Post-Sim Q's. 10 terms. Making a Monitor O2 saturation levels Respiration: 24. Blood pressure:riate. 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. 13 terms. PO (Children <3 yr): 1040 mg in 14 divided doses. 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 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. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Use preservative-free formulation. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Before discharging Brittany Long and her family, I would educate them on how to PO (Children 1223 mo/1823 lb): 75 mg every 68 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? She has been hospitalized twice, once at age 4 years Would you like to proceed ? syndrome can develop in children with sickle cell crisis. b) Hide med in applesauce or ice cream and have the parent feed the pt Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Over time, the What would be the most appropriate med for the nurse to administer? Temp: She was, patient has been complaining of right lower leg pain over the last 2 days. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. PROTOTYPE: Morphine. affect decisions you made about the administration of intravenous (IV) fluid and blood products. : 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. Pediatric OTC Dosing d) decreased hgb, increased platelet, greatly elevated reticulocyte. With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. Monitor her 02 sat and keep above 94%. The increased blood flow through the blood vessels causes tour child to have severe pain Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: 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.