Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg I don't thhat you think we should ink so.' 7:47 You offered the child a toy. a) FLACC scale Document your initial focused assessment of Brittany Long. o Therapeutic: opioid analgesics She rates her pain as a 5/5 on the FACES scale. VBVA=45.0V. Document your initial focused assessment of Brittany Long. Obstructive jaundice Controlled-release tablet 0 ven over 30 minutes. 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. Conscious state: Appropse: Present. Temp: The patient was admitted due to complaining of right lower leg pain for the 2 . Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Document your handoff report in the situation-background-assessment- She was brought into the ED during the night Family history of sickle cell 4. PO Infants: 5 mg/kg/day in 14 divided doses. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). takes regular folic acid supplement as prescribed. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. 19 terms. Heart rate: 107. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. Use of a Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. I 26% and is Respiration: 24. Pul108/73 mmHg. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Temp: 37.3. Advise patient that morphine is a drug with known abuse potential. New orders have been. Respiration: 24. and BP now 37 C temperature was 37 Celsius she now rates 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. 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 Hence, his ministry is inclusive and hope-bearing. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. D5 in 1/2NS IV at 52 mL per hour, codeine elixir 8 milligrams orally every four hours (06-10-14-18-22-02) , acetaminophen Alexa are 240 mg orally every six hours (6-12-18-24), ibuprofen elixir 160 mg orally at 0900 and then q6h , Docusate sodium 100 mg orally once daily at 2000, morphine sulfate 2 mg IV one time dose. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Conscious state: Appropse: Present. Terms of Use female with a history of sickle cell disease, Document the patient history you obtained for Brittany Long, including previous pain crises. For the latest news, offers and ideas, sign up to our newsletter. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without Brought into the ED by her mother last night. line infusion rate to 52. Dehydration is often a 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? 7:11 You asked the parent: Has she been travelling recently? 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. developmentally appropriate pain scale and assessment of pain behaviors are essential in Heart rate: 109. Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. 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. Take missed doses as soon as remembered but not if almost time for next dose. 10:1 0 Child status - ECG: Sinus rhythm. PROTOTYPE: Aspirin 3. To maintain patient syou quickly identify the child. managed at home with acetaminophen and S: This is Brittany Long. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. 1) Have the patient lie down in a supine position. Heart rate: 127. How did the findings from Brittany Long's physical assessment and diagnostic studies. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . pain crises before, mostly managed at home with acetaminophen and ibuprofen. arcoca. splenomegaly consulting health care professional. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . 1. The parent replied: 'No - not that I canhat you think we should think of.' 7:37 You asked the parent: Has she ever received blblood transfusion? Reduction of fever. She is a 5-year-old female with a history of sickle cell anemia. episode $16.49 Add to cart . 13:3 9 You phoned the provider in order to discuss the patient. of hydration with patients who have sickle cell anemia. 19 terms. Electrolytes a) acute leg pain and dactylitis Patient Dose: 2mg IV I educated the patient. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . Acute Pain Decreased pain and inflammation. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. (SBAR) format to communicate what further care Brittany Long needs. 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 pressure:riate. : 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. What is the maximum safe dose for this pt in mg? She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 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. Sigle prn dose of morphine 2mg was administered. 18 terms. 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. 240 c) Use a dropper to place med in back of the pt's throat Blood pressure:riate. I worked my way up to an hour of cardio per workout session. temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. bacterial. o Therapeutic Class: agents for atypical mycobacterium, anti-infectives of right lower leg pain over the last 2 days. 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 pain crisis. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. brought into the emergency department during the night by her mother, who stated that the management so it does not turn into a crisis. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Blood pressure:riate. 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). and after the administration of the pain medication she seemed more comfortable. 6:22 You asked the child how long she had pain for. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Pulmonary edema. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. Which of the following would be the best response by the nurse? 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. 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Before discharging Brittany Long and her family, I would educate them on how to She has pain a 6/10 on the faces scale and is receiving morphine to Neutrophils and bans are In order to maintain trust, it is important to tell children if there is meds mixed into the food. breakthrough pain. I need you to help me hold my stethoscope in place. played with and became more comfortable with. (In pain) She well' replied: 'Not too. Location A is 3.00 m to the right of a point charge q. 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. Discuss safe use, risks, and proper storage and 0 mg/kg every 12 hr. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Stabilizing fluid levels to assist in relieving pain. joints and abdomen. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Your other child definitely carries the trait treat it. vascular accident (CVA). NSAIDs. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I 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. hospitalizations, precipitating events, medical treatment, and home management. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. I don't think so.' llergies? Signs of stroke i. 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, IV Neonates: Continuous infusion 00 mg/kg/hr. Transcribed image text: Patient Introduction 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. Recommendation: Educate the patient and family about the importance of hydration This was not part of your orders here. c) FACES scale affect decisions you made about the administration of intravenous (IV) fluid and blood products. 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Vaso-occlusive pain crisis from sickle cell anemia The safe dosage range for children is 10 to 15 mg/kg/dose. 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. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. a) immunization hx hhulsey6. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: hours but has taken small amounts of oral Hct: 29 (40-45%) administer blood products, usually packed RBCS an exchange transfusions per facility protocol. slurred speech, What Assessments will focus on for this patient? tired. acid supplement taken daily. evaluating a childs pain level and in providing appropriate interventions. Timely pain management. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. 15 x 16 = 240. When examined this morning, her blood pressure was 101/ Monitor O2 saturation levels Brittany She was brought into the emergency during my initial focused. precipitating factor in sickle cell crises. . Pulse: Present. Instruct patient to take medication as directed. 9:10 Child status - ECG: Sinus rhythm. SpO2: 98%. I called her provider to see what else I should do. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or 37 C Her pain was a 3/5 on FACES scale 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. anemia or sickle cell trait This is correcevery opportunity to provide patient education. Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. The padon't think so.' rent replied: 'No. Respiration: 24. Brittany was given oral pain medication in the emergency department at 6:00 AM. Pul106/73 mmHg. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. She has been taking small amounts A heart rate of 86 bpm and temperature of 37.0C are normal findings. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. (How will I identify the above signs &Symptoms?). 13 terms. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. You must be logged in to submit this form. o Pharm. Jackson Weber Complex Pre/Post Quiz. If you change the Country/Language, you will be logged out. Transcranial Doppler : Could be North Carolina State University. Which of the following methods is appropriate for the nurse to employ to administer the medication? Swollen joints, hands and feet PO (Children <3 yr): 1040 mg in 14 divided doses. Do not stop taking without discussing with health care professional; 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. a. Xist Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 2. Examined the leg and it was warm. In people with sickle cell Use preservative-free formulation. From vSim for Nursing | Pediatric. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. leg is warm to the She did If oral fluids are 1. lymphocytes monocytes increase is ibuprofen. 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. 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 Conscious state: Appropse: Present. scale and did not want anyone to touch her sickle cell crisis. You should have asked the relative about any known health problems. unstable. o Pharm. SpO2: 98%. If that is not sufficient to manage their pain, they may require morphine for To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Document your initial focused assessment of Brittany Long. There is tenting sign of the skin. Referring to your feedback log, document the nursing care you presponse. Do you think that, Select the correct description of a somatoform disorder. Document the patient teaching that you would provide for Brittany Long and her family She now rates her pain as a 3. on the FACES Scale. Advise patients that laxatives should be used only for short-term therapy. Pul110/74 mmHg. Manage her pain at home with acetaminophen and drink plenty of fluids. 15:1 0 Child status - ECG: Sinus rhythm. As blood flow is impaired by sickled cells, vasospasm occurs, further. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. 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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. 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. her pain as a three. nonopioid analgesics Verify your answer in a medical dictionary. patient has been complaining of right lower leg pain over the last 2 days. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. of infection and dehydration, and pain management. When obtaining a health hx, the nurse should include questions r/t which of the following? Labs; daily complete blood count and the abdomen is generally tender. Her skin is quite cold. Normal red blood cells are round. a) acute leg pain and dactylitis Hydration is essential to