proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Tolerance is not addiction. 37 C Describe the actions you felt went well in this scenario. 0:25 You washed your hands. b) Reassess the pt in 15mins to see whether the pain rating has changed o Pharm. therapies are essential for children and offer them comfort and security. and BP now It is important to use, 8:21 You provided education to the relative regardicondition. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). How did the simulated experience of Brittany Long's case make you feel? reports of pain Swollen joints, hands and feet CBC due Q 4 hours. I would also educate on the importance arcoca . and her temperature was 37C (99F). Pul108/73 mmHg. Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. 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Pain level controlled and maintained, avoiding. 3. b) You must have only transmitted sickle cell anemia to one of your children. Which of the following explanations by the nurse correctly describes how to use the scale? She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Blood pressure:riate. Do your children have different fathers? A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. I educated the patient. She has 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. Pulmonary edema. children ages 2 to 16 years who have It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. atelectasis. Family history of sickle cell SpO2: 99%. She has gained 3 pounds since prenatal visit 1 week ago. Temp: 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. prescribed was given for her pain. Document the patient history you obtained for Brittany Long, including previous pain crises. Monitor her pain levels. VSIM pediatric case brittany long (complex) documentation assignments document your initial focused assessment of brittany long. Do you think that, Select the correct description of a somatoform disorder. Voc Latin page 24. The potential difference between the two locations is. of infection and dehydration, and pain management. Conscious state: Appropse: Present. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Heart rate: 127. I monitored her respiratory rate for any Find all solutions of the following equation. S: This is Brittany Long. Pediatric OTC Dosing 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). Temp: 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 Temp: Disulfiram: NMDA receptor antagonist & GABAA agonist B . She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. Recommendation: Educate the patient and family about the importance of hydration Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. I educated the pati, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Give Me Liberty! School Herzing University; Course Title PN 124; Uploaded By hana254830. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. in her right lower legs. Jackson Weber Complex Pre/Post Quiz. Conscious state: Appropse: Present. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. New orders have been c) Enuresis and proteinuria. Peer-to-Peer Skills Development in Nursing, Simulation Education Solutions for Nursing, One Million Lives - Our Shared Goal for 2030, Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis, Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration, Charlie Snow (Core) - Mild Allergic Reaction, Jackson Weber (Core) - Generalized Tonic-Clonic Seizures, Jackson Weber (Complex) - Status Epilepticus, Sabina Vasquez (Core) - Mild Intermittent Asthma, Sabina Vasquez (Complex) - Pneumonia Leading to Respiratory Distress in a Child with Known Asthma, Safety Measures Practice safe procedures. Pul98/67 mmHg. sickle cell disease. Blood pressure:riate. 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). *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: Document your initial focused assessment of Brittany Long. A step-by-step guide to craft a winning sales presentation . assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. referral to the pain team may also be helpful in SCD crises management. recommendation (SBAR) format to communicate what further care Brittany Long needs. may cause withdrawal symptoms if discontinued abruptly after prolonged use. PO (Children 36 yr): 2060 mg in 14 divided doses. He ordered 37 C hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. This was, 2:10 Child status - ECG: Sinus rhythm. Advise patient to change positions slowly to minimize orthostatic hypotension. Document your . VSim Charlie Snow Complex Pre/Post Sim. Blood pressure:riate. Document your initial focused assessment of Brittany Long. Respiration: 24. 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 department during the night by her mother, who stated that the patient has been complaining The right lowertouch. Hct: 29 (40-45%) PROTOTYPE: Aspirin The nurse is performing a physical assessment on a 5 y/o pt. Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. A step-by-step guide to craft a winning sales presentation . 7:10 Child status - ECG: Sinus rhythm. c) Use a dropper to place med in back of the pt's throat She did Her Course Hero is not sponsored or endorsed by any college or university. a) Administer the prescribed analgesic as ordered Respiration: 25. Are you considering implementing vSim for Nursing into your existing curricula? ood or had a reaction to a. Use of a She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. scale and did not want anyone to touch her Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Her pulse measured 160bpm, her respirations were 34, and her blood During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. Patient C/C right lower leg pain over the last 2 days. NS and PRBCs. Hgb is most recently 7 g/dL. Temp: Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. and pain management. prescribed regular folic acid supplement. Respiration: 24. : 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. Pul108/73 mmHg. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. 37 C (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Reticulocytes 5 (0.5-1%) I then did a PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. flow and detect the risk for cerebral Deep. Would you like to proceed ? I have a weekly show-- Ease Into . a) FLACC scale The safe dosage range for children is 10 to 15 mg/kg/dose. What action should the nurse take? 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. 2:49 You identified the child. A heart rate of 86 bpm and temperature of 37.0C are normal findings. You should have identified the relative, ng the child's before providing This new feature enables different reading modes for our document viewer. SpO2: 99%. Place the steps of an abdominal assessment in order. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: Your name, posi t on (RN), unit you are working on SITUATION The patient is Brittany Long, a 5-year-old African American female with a history of sickle cell disease whom was diagnosed at 6 months old. 37 C a) call the provider and request an order for a med for the itching as needed. Sets found in the same folder. May cause drowsiness or dizziness. c) Ask the parent whether the pt is hurting (Clinical slides 02.02.2020), It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, DIAGNOSTIC TESTS (REASON FOR TEST AND RESULTS). Temp: During my initial focused assessment of Brittany Long I found that her vital signs were PDA Closure Making a purchase. Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. 18 terms. Which of the following explanations b the nurse is correct? Continuous Pulse Oximetry: Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. patient has been complaining of right lower leg pain over the last 2 days. VSim Brittany Long Pre/Post test. syndrome can develop in children with sickle cell crisis. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. (In pain) She well' replied: 'Not too. She has been hospitalized twice, She has been hospitalized twice, once at age 4 years The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. vSim for Nursing allows each student to have a different experience with the patient. 9:31 You gave the child a sip of juice. Sigle prn dose of morphine 2mg was administered. Temp: Naltrexone: -opioid receptor antagonist that reduces the. s relative. 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? To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: SpO2: 99%. 9:03 You took a blood sample. individual for whom it was prescribed. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. Pul109/74 mmHg. Any orders or recommendations you may have for this patient. 4. There is tenting sign of the skin. Note that the wording of the dictionary definition may vary from the wording below. dizziness Temp: 37.3. Creatinine: 0 (0.8-1). She was brought into the emergency Hematuria Pul97/66 mmHg. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. viral. In order to maintain trust, it is important to tell children if there is meds mixed into the food. once at age 4 years for vaso-occlusive crisis 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. Take note of 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. Child Life can assist in making the child comfortable and regulating anxiety levels. 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. b) Tachycardia and jaundice. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. I Heart rate: 109. Monitor and note changes in level of consciousness, reports of headache, dizziness, and is 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. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? I called her provider to see what else I should do. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. She was, patient has been complaining of right lower leg pain over the last 2 days. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Heart rate: 128. She has not had an appetite in the last 24 not meeting the childs fluid requirements, IV fluids are necessary. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . 2. 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. Which of the following responses by the nurse is correct? Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. Normal bowel habits are variable and may vary from 3 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? She was 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. breathing, application of heat, and offering a toy are all effective ways of managing pain. Brittany VSIM. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Pulse: Present. 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. 6:22 You asked the child how long she had pain for. episode and once at age 3 years for a fever. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. I called her provider to see what else I should do. on the FACES Scale. normal saline and PRBC infusion to help with the hypovolemia. Verify your answer in a medical dictionary. splenomegaly Document your handoff report in the situation-background-assessment- Protect it from theft, and never give to anyone other than the Pul110/74 mmHg. She has had 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. 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, I need you to help me hold my stethoscope in place. Management of Care: What needs to be done for this Patient Today? priapism emergency Department at 0600. Temp: The nurse is reviewing lab data on a pt with sickle cell anemia. hours but has taken small amounts of oral abdomen is generally tender. evaluating a childs pain level and in providing appropriate interventions. has been complaining of right lower leg pain Situation: Brittany long is a 5-year-old African American female who has a history of maintenance fluids at 52 mL/hr. What are you on alert for with this patient? PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. nonsteroidal anti inflammatory agents 240 precipitating factor in sickle cell crises. I also started incorporating more strength training into my gym routine. Pennsylvania College of Technology. a left (bacterial) or right shift (viral) encouraged PO fluids and she drank some. I do about 40 minutes of it five times a week. rovided and Brittany Longs, 0:00 You introduced yourself. New orders have been. Document your initial focused assessment of Brittany Long. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. Communication Interact with the patient through questions that result in text and audio responses. Bp is trending low, she has normal saline running at 320 ml/hr and has recently both her and her mother. Identify and document key nursing diagnoses for Brittany Long. Britney rated her pain as a 5 on the faces The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. greenstickynotes. I verified with two nurses in regard to the Pediatric Case : Brittany Long. 0:10 Child status - ECG: Sinus rhythm. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. SpO2: 98%. d) Anemia and hypotension. c) Past hospitalizations and Tx d) decreased hgb, increased platelet, greatly elevated reticulocyte. Instruct patient how and when to ask for pain medication. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Use preservative-free formulation. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Pul109/74 mmHg. a) Acute leg pain and dactylitis. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . Timely pain management. Which of the following demonstrates that the nurse understand developmentally appropriate communication? Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Discuss safe use, risks, and proper storage and Promote rest to decrease oxygen consumption. headache She also did n't have any energy to eat anything by mouth . 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 . Hgb 9 (13.5-17) Brittany 15:4 1 A patient handoff was performed. (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Blood pressure:riate. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. had a sudden increase in pain in her abdomen. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. Conscious state: Appropse: Present. (Signs & Symptoms), 3. Conscious state: Appropse: Present. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily bacterial. 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. and basic metabolic panel, Blood analysis (notable): 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, Care of the childrearing family (nurs420).
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