Brittany Long was diagnosed with sickle cell disease at 6 months old. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. 15 x 16 = 240. viral. and educated the mother about signs of a reaction. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. PRBCS. over the last 2 days. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Take missed doses as soon as remembered but not if almost time for next dose. children ages 2 to 16 years who have Communication Interact with the patient through questions that result in text and audio responses. pain 02 mg/kg/hr. arcoca . of right lower leg pain over the last 2 days. b) Tachycardia and jaundice. 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. 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. 1. Document the patient history you obtained for Brittany Long. department during the night by her mother, who stated that the patient has been complaining A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. The. 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. Continuous infusion, sickle cell or cancer A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. Making a prevention of infection and dehydration, and pain management. 7:11 You asked the parent: Has she been travelling recently? The child looked slightly IF you have four children, one or 25% will have sickle cell anemia. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? She also didn't have any energy to eat anything by mouth. Cross), 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), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), 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), Give Me Liberty! You don't have to be crying to be hurting a lot. Caution patient to call for assistance when ambulating : 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. Pulmonary edema. There is tenting sign of the skin. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without This is correcevery opportunity to provide patient education. 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. Assess dehydration status via CBC, Urinalysis and strict I/O. Pul98/67 mmHg. flow and detect the risk for cerebral 6a Daily Routine. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Disulfiram: NMDA receptor antagonist & GABAA agonist B . Manage her pain at home with acetaminophen and drink plenty of fluids. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. I have given her morphine 2 mg IV Push and have also bolused Brittany rated her pain 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. Fluid and Electrolyte levels stabilized and maintained. 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. tired. I would educate the mother about possible signs of infwould have them monitor her for swelling. . Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options respiratory depression. She has pain a 6/10 on the faces scale and is receiving morphine to 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? of oral fluids and continues to receive hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. B: She came in with right lower leg pain, and that has since been stabilized, but she has Respiration: 24. and her temperature was 37C (99F). Would you like to proceed ? Deep. Her Acute chest The breath sounds are clear and equal bilaterally. She did The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. 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. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Document the patient teaching that you would provide for Brittany Long and her family Use preservative-free formulation. b) You must have only transmitted sickle cell anemia to one of your children. Respiration: 15. pallor, pale mucous membranes Observe for manifestations c) Drinking to much water can trigger another crisis. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. 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. ven over 30 minutes. 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. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. VSim Charlie Snow Complex Pre/Post Sim. . Hematuria a) acute leg pain and dactylitis ECG: normal Sinus rhythm. 2) Inspect abdomen for size and shape. Abdominal pain Acute Pain The patient was diagnosed with sickle cell anemia and was in a Upto date with . joints and abdomen. vSim - Brittany Long. The safe dosage range for children is 10 to 15 mg/kg/dose. management so it does not turn into a crisis. temperature was 37 Celsius she now rates episode and once at age 3 years for a fever. Controlled-release tablet 0 in her right lower legs. She rates her pain as a 5/5 on the FACES scale. NS and PRBCs. What action should the nurse take? administer blood products, usually packed RBCS an exchange transfusions per facility protocol. SpO2: 98%. Normal red blood cells are round. of infection and dehydration, and pain management. The padon't think so.' rent replied: 'No. The pt is lying quietly in bed watching TV. Impaired Gas Exchange 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. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Bp is trending low, she has normal saline running at 320 ml/hr and has recently c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Referring to your feedback log, document the nursing care you provided and 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? You must be logged in to submit this form. 8:10 Child status - ECG: Sinus rhythm. Jackson Weber VSim Post-Sim Q's. 10 terms. Wolters Kluwer Health. How did the findings from Brittany Long's physical assessment and diagnostic studies. CLASSIFICATION: She now rates her pain as a 3. Jackson Weber VSim Post-Sim Q's. 10 terms. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she 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. 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 Heart rate: 126. Pul106/73 mmHg. not meeting the childs fluid requirements, IV fluids are necessary. And Hct. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. managed at home with acetaminophen and Brittany Long is a 5-year-old African American female with a history of sickle cell disease, 18 terms. 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. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached and after the administration of the pain medication she seemed more comfortable. Conscious state: Appropse: Present. Identify and document key nursing diagnoses for Brittany Long. 9:03 You took a blood sample. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? The nursing care for Brittany Long began with obtaining a set of vitals. From vSim for Nursing | Pediatric. hands and feet cool to touch. 2. Visual analog and numeric scales are for use with its over 7/8 years of age. Blood pressure:riate. Stabilizing fluid levels to assist in relieving pain. I then preformed an assessment on her abdomen. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . Keep Pain management by evidence of pain in right lower leg Temp: Pediatric Case 7: Brittany Long (Core) Documentation Assignments. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years 0 mg/kg every 12 hr. 37 C 4. Document your initial focused assessment of Brittany Long. Conscious state: Appropriase: 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. Four months . Instruct patient how and when to ask for pain medication. It is not necessary to give combining terms for words in parentheses. b) Reassess the pt in 15mins to see whether the pain rating has changed Advise patients that laxatives should be used only for short-term therapy. Verify your answer in a medical dictionary. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. 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. 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. normal saline and PRBC infusion to help with the hypovolemia. Describe the actions you felt went well in this scenario. 1. spleen, leading to anemia. Which of the following would be the best scale to use w/ this pt? Temp: A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. atelectasis. Temp: 37.3. She has had pain crises before, mostly managed at Are you considering implementing vSim for Nursing into your existing curricula? Initial focus assessment was the patients pain and location. 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 Blood pressure:riate. 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. 10:1 0 Child status - ECG: Sinus rhythm. signs Q2 hours. o Pharmacologic: opioid agonists Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Neutrophils and bans are o Pharm. I IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. 0:10 Child status - ECG: Sinus rhythm. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. c) Past hospitalizations and Tx Reticulocytes 5 (0.5-1%) 4. Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? She is asleep but is responsive when awakened. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. by her mother, who stated that the patient Promote rest and provide adequate fluids and nutrition. Temp: vSim for Nursing allows each student to have a different experience with the patient. bacterial. Do not stop taking without discussing with health care professional; When examined this morning, her blood pressure was 101/ Child Life can assist in making the child comfortable and regulating anxiety levels. antirheumatics Heart rate: 126. She has been hidy_esther. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and avoid a sickle cell crisis in the future. 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Class: macrolide Heart rate: 107. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth I need you to help me hold my stethoscope in place. Hypovolemia by evidence of pale extremities (Signs & Symptoms), awakened. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses.