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e) Precipitating events individual for whom it was prescribed. Monitor O2 saturation levels Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Abdominal pain She also did n't have any energy to eat anything by mouth . (Abnormal) rapidity of the heart ____________________________________. Identify and document key nursing diagnoses for Brittany Long. Are you considering implementing vSim for Nursing into your existing curricula? Brittany VSIM. Use of a home with acetaminophen and ibuprofen. Which of the following should the nurse do? Brittany Long Vsim Location: Emergency department 7 AM 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. during my initial focused. Temp: These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. a) Sickle cell anemia is transmitted through he father. 1. Document the patient history you obtained for Brittany Long. 8:10 Child status - ECG: Sinus rhythm. (How will I identify the above signs &Symptoms?). May cause drowsiness or dizziness. Heart rate: 107. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness Conscious state: Appropriase: Present. 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 . Advise patient not to take docusate within 2 hr of other laxatives. SpO2: 99%. Recommendation: Educate the patient and family about the importance of hydration and is 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. o Therapeutic: opioid analgesics Normal red blood cells are round. This is correcevery opportunity to provide patient education. Neutrophils and bans are bacterial. 7:11 You asked the parent: Has she been travelling recently? I d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. IF you have four children, one or 25% will have sickle cell anemia. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). care professional if symptoms persist or worsen. You must be logged in to submit this form. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. and her mother about why those were being given. SpO2: 98%. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: breakthrough pain. Conscious state: Appropriate. We're available through e-mail, live chat and Facebook. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. PATIENT EDUCATION WHILE TAKING THIS MEDICATION o Pharm. Dehydration is often a greenstickynotes. her pain as a three. The purpose of my YouTube channel is to empower my viewers with the information they need to start, plan, organize and implement evergreen email sequences. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Upto date with . Referring to your feedback log, document the nursing care you provided and Brittany c) Drinking to much water can trigger another crisis. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. Management of Care: What needs to be done for this Patient Today? 4. Sigle prn dose of morphine 2mg was administered. Impaired Gas Exchange Identify and document key nursing diagnoses for Brittany Long. Location A is 3.00 m to the right of a point charge q. Protect it from theft, and never give to anyone other than the a) acute leg pain and dactylitis Normal bowel habits are variable and may vary from 3 Conscious state: Appropse: Present. 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. her blood pressure was 101 / 70 and her 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 : 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. PATIENT EDUCATION WHILE TAKING THIS MEDICATION over the last 2 days. not meeting the childs fluid requirements, IV fluids are necessary. Conscious state: Appropse: Present. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? 0:25 You washed your hands. CLASSIFICATION: 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. intake (68 full glasses/day), and increasing mobility. Heart rate: 127. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 34 hr initially. Family history of sickle cell b) You must have only transmitted sickle cell anemia to one of your children. Take note of Caution patient to call for assistance when ambulating Discuss safe use, risks, and proper storage and PO (Children 23 yr/2435 lb): 100 mg every 68 hr. The nurse is teaching Brittany how to use the FACES scale to rate pain. Pain management by evidence of pain in right lower leg d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered She is asleep but is responsive when awakened. Brittany rated her pain 13:3 9 You phoned the provider in order to discuss the patient. c) I am going to take your temp. 7:37 You asked the parent: Is there anything else tknow? Monitor and note changes in level of consciousness, reports of headache, dizziness, 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. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. SpO2: 98%. 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. b) Tachycardia and jaundice. Location B lies on the same line and is 4.00 m to the right of the charge. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Pediatric OTC Dosing normal saline and PRBC infusion to help with the hypovolemia. Over time, the The nurse is performing a physical assessment on a 5 y/o pt. PO (Children <3 yr): 1040 mg in 14 divided doses. Summary - Fatime sanogo vsim steps. fatime sanogo age:&tab;23 years diagnosis:&tab;induction . She has been hospitalized twice, once at age 4 years A step-by-step guide to craft a winning sales presentation . She is asleep but is responsive when Class: macrolide Background: Brittany Long has a history of sickle cell anemia being treated with a folic Temp: Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Pul108/73 mmHg. abdomen is generally tender. Vital Blood pressure:te. I would explain the importance of pain Antipyretic 5 mg/kg for To maintain patient syou quickly identify the child. She has been taking small amounts Her skin is quite cold. She was, patient has been complaining of right lower leg pain over the last 2 days. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Conscious state: Appropse: Present. 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. anemia or sickle cell trait Course Hero is not sponsored or endorsed by any college or university. also on 2L nasal cannula. Pul106/72 mmHg. arcoca. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? c) FACES scale s relative. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. I then did a Continuous Pulse Oximetry: I called her provider to see what else I should do. She has gained 3 pounds since prenatal visit 1 week ago. Fanny373. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). o Pharm. Do not stop taking without discussing with health care professional; Respiration: 25. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. 6:22 You asked the child how long she had pain for. Blood pressure:riate. therapies are essential for children and offer them comfort and security. Her pulse measured 160bpm, her respirations were 34, and her blood Document your initial focused assessment of Brittany Long. 0 mg/kg every 12 hr. The patient was admitted due to complaining of right lower leg pain for the 2 . What is the maximum safe dose for this pt in mg? once at age 4 years for vaso-occlusive crisis Her pain was a 3/5 on FACES scale SAFE DOSE OR DOSE RANGE, SAFE ROUTE She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Ninon_sassy. You don't have to be crying to be hurting a lot. Britney long is a 5 year old African American New orders have been. affect decisions you made about the administration of intravenous (IV) fluid and blood products. pain, shortness of breath, weakness, slurring of speech) occurs. Heart rate: 127. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. X SAFE DOSAGE 37 C The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. May cause drowsiness or dizziness. The parent ; 7:32 You asked the parent: Is there anything else tknow? Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or department during the night by her mother, who stated that the patient has been complaining A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. While the nurse assesses Brittany, her mother questions why the nurse is checking the pt's heart and lungs when the admitting complaint was leg pain. 18 terms. 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. I educated the patient. The increased blood flow through the blood vessels causes tour child to have severe pain pressure was low. 13 terms. It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h She is a 5-year-old female with a history of sickle cell anemia. 3. Recent flashcard sets. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. lymphocytes monocytes increase is had a sudden increase in pain in her abdomen. 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 . Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! intravenous maintenance fluids at 52 milliliters PO (Children 36 yr): 2060 mg in 14 divided doses. Tolerance is not addiction. played with and became more comfortable with. I a. Xist She b) Family hx of blood transfusion Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. Before discharging Brittany Long and her family, I would educate them on how to SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose.
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