and BP now To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: May cause drowsiness or dizziness. over the last 2 days. S: This is Brittany Long. Heart rate: 128. temperature was 37 Celsius she now rates For the latest news, offers and ideas, sign up to our newsletter. 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 intravenous maintenance fluids at 52 milliliters before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation c) Past hospitalizations and Tx Heart rate: 126. home with acetaminophen and ibuprofen. You should have asked the relative about any known health problems. Brittany was given oral pain medication in the emergency department at 6:00 AM. 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 Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Which of the following explanations b the nurse is correct? SpO2: 98%. She has been hospitalized twice, once at age 4 years Store out of sight and reach of children, and in a location not accessible by others. 37 C PO (Children 36 yr): 2060 mg in 14 divided doses. Britney rated her pain as a 5 on the faces intake (68 full glasses/day), and increasing mobility. Pul106/72 mmHg. Deep. Caution patient to call for assistance when ambulating Initial focus assessment was the patients pain and location. 11:1 0 Child status - ECG: Sinus rhythm. I/O can be calculated by UAP. Her pain was a 3/, in her right lower legs. of hydration with patients who have sickle cell anemia. Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health Labs; daily complete blood count d) Frequency of vaso-occlusive crises Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . vSim for Nursing allows each student to have a different experience with the patient. of infection and dehydration, and pain management. Diagnosed with sickle cell disease at age 6 months. Creatinine: 0 (0.8-1). She is a 5-year-old female with a history of sickle cell anemia. normal saline and PRBC infusion to help with the hypovolemia. 2:49 You identified the child. He ordered, normal saline and PRBC infusion to help with the hypovolemia. You must be logged in to submit this form. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg 13:2 3 You examined the child's legs. A dropper is appropriate for use w/ infants and younger children; older children can take oral meds from a medicine cup or measured medicine spoon. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Course Hero is not sponsored or endorsed by any college or university. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? Document your initial focused assessment of Brittany Long. What would be the most appropriate med for the nurse to administer? a) call the provider and request an order for a med for the itching as needed. per hour period when examined this morning SpO2: 99%. Britney was given oral pain medication in the 13:3 9 You phoned the provider in order to discuss the patient. PRBCS. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. She has not had an appetite in the last 24 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. What action should the nurse take? Skip to document. Pul110/74 mmHg. Use preservative-free formulation. Voc Latin page 24. IF you have four children, one or 25% will have sickle cell anemia. 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. Electrolytes awakened. She also didn't have any energy to eat anything by mouth. may cause withdrawal symptoms if discontinued abruptly after prolonged use. used to assess Intercranial vascular Conscious state: Appropse: Present. Management of Care: What needs to be done for this Patient Today? decreased oxygen) Obstructive jaundice Pennsylvania College of Technology. every 34 hr, maximum: 15 mg/dose. 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). She is asleep but is responsive when awakened. The patient was diagnosed with sickle cell anemia and was in a New orders have been. Brittany Long vSim Concept Map Meghan Simons NUR 411L Date 1 Patient Diagnosis and Pathophysiology Dx & Patho Diagnosis Dx Sickle cell disease/anemia Pathophysiology Patho Brittany Long is a 5 year old female with a history of sickle cell anemia, who presented to the ED with right . faces scale. Monitoring oxygenation, use of incentive spirometry, hydration, and The child looked slightly Hydration is essential to I then preformed an assessment on her abdomen. Conscious state: Appropse: Present. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). SpO2: 98%. Assess patient and caregiver knowledge of how to avoid crisis. Abdominal pain Conscious state: Appropriase: Present. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. pain, shortness of breath, weakness, slurring of speech) occurs. Assessment for signs and symptoms of dehydration is Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. hidy_esther. Brittany VSIM. Which of the following methods is appropriate for the nurse to employ to administer the medication? 37 C 20 terms. Are you considering implementing vSim for Nursing into your existing curricula? has been complaining of right lower leg pain (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE diagnosed at six months old and has been Referring to your feedback log, document the nursing care you provided and Brittany Monitor her pain levels. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. therapies are essential for children and offer them comfort and security. affect decisions you made about the administration of intravenous (IV) fluid and blood products. Heart rate: 109. of oral fluids and continues to receive Recommendation: Educate the patient and family about the importance of hydration I f dehydration, look at her legs frequently. She looked visually uncomfortable and reported feeling pain, a 6/10 on the The spleen is enlarged, 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. Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer Describe the actions you felt went well in this scenario. SpO2: 99%. What are you on alert for with this patient? 7:11 You asked the parent: Has she been travelling recently? arcoca. treat it. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Heart rate: 126. SpO2: 99%. blood and then administered it. 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. 37 C both her and her mother. Dehydration is often a A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. a) I want to listen to you breathe. Britney long is a 5 year old African American Pediatric Case 7: Brittany Long (Core) Documentation Assignments. a. Xist Document your . splenomegaly I need you to help me hold my stethoscope in place. Morphine 2mg IV given as a) Sickle cells cause increased blood flow throughout the body. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) ibuprofen. o Ther. Look for signs oection such as fever and shortness of breath. Wolters Kluwer Health. 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 The. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. her blood pressure was 101 / 70 and her NSAIDs. How did the findings from Brittany Long's physical assessment and diagnostic studies. Pul108/73 mmHg. a) Sickle cell anemia is transmitted through he father. leg is warm to the SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 19 terms. __________mg. occlusive crisis. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Swollen joints, hands and feet I have given her morphine 2 mg IV Push and have also bolused Respiration: 24. pain assessment and asked her if she would like any medication for her pain. She has been taking small amounts Tolerance is not addiction. There is tenting sign of the skin. 3. Controlled-release tablet 0 Dehydration Synthesis Student Exploration Gizmo, Week 1 short reply - question 6 If you had to write a paper on Title IX, what would you like to know more about? precipitating factor in sickle cell crises. What are you on alert for with this patient? She has had atelectasis. 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 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. c) I am going to take your temp. CBC due Q 4 hours. New orders have been 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 Educate patient and family on nutritional and fluid needs. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Reduction of fever. Conscious state: Appropse: Present. 9:10 Child status - ECG: Sinus rhythm. She is on D5NS fluids at 52 mL/hr. doses. Brittany 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). brittany long complex vsim documentation. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. 1. are inadequate (extended release). We're available through e-mail, live chat and Facebook. The increased blood flow through the blood vessels causes tour child to have severe pain kuuleinani1102. Advise patients that laxatives should be used only for short-term therapy. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. 2. Respiration: 24. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I d) Anemia and hypotension. 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. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. 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!
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