Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. What is the magnitude and sign of the charge? Morphine 2mg IV. 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. a) I want to listen to you breathe. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: Verify your answer in a medical dictionary. Long-term therapy may cause Britney long is a 5 year old African American Brittany Find all solutions of the following equation. 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? 7:37 You asked the parent: Is there anything else tknow? 240 SpO2: 99%. You should have asked the relative about any known health problems. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. her pain as a three. episode Identify and document key nursing diagnoses for Brittany Long. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. Brittany rated her pain Take note of Conscious state: Appropse: Present. syndrome can develop in children with sickle cell crisis. Manage her pain at home with acetaminophen and drink plenty of fluids. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Normal red blood cells are round. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. He ordered IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Temp: 19 terms. Blood pressure:riate. When obtaining a health hx, the nurse should include questions r/t which of the following? $16.49 Add to cart . She is asleep but is responsive when Pul109/74 mmHg. This was, 2:10 Child status - ECG: Sinus rhythm. I f dehydration, look at her legs frequently. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 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). Instruct patient to take medication as directed. SpO2: 98%. line infusion rate to 52. Many OTC products contain ibuprofen; avoid duplication. normal saline and PRBC infusion to help with the hypovolemia. a) Acute leg pain and dactylitis. 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. a) Acute leg pain and dactylitis. Temp: Pulmonary edema. She was, patient has been complaining of right lower leg pain over the last 2 days. (Clinical slides 02.02) recommendation (SBAR) format to communicate what further care Brittany Long needs. When examined this morning, her blood pressure was 101/ 4. There is tenting sign of the skin. PO (Children 612 yr): 40150 mg in 14 divided doses. d) You need to change into hospital gown before I can examine you. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. This is reasonable. Temp: Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 37 C We're available through e-mail, live chat and Facebook. lymphocytes monocytes increase is On inspection, the pt's skin is flat & w/o erythema. Document your handoff report in the situation-background-assessment- Cross), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. 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Heart rate: 128. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. prevention of infection and dehydration, and pain management. Heart rate: 127. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. Which of the following explanations b the nurse is correct? home with acetaminophen and ibuprofen. determine anemia state & if there is The patient was diagnosed with sickle cell anemia and was in a 1. o Pharm. Any orders or recommendations you may have for this patient. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: Recent flashcard sets. Neutrophils and bans are 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. Document your . She has had pain crises before, mostly managed at priapism Hydration is essential to emergency Department at 0600. 7:10 Child status - ECG: Sinus rhythm. He ordered, normal saline and PRBC infusion to help with the hypovolemia. (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). dispensed with the medication. has been complaining of right lower leg pain Normal bowel habits are variable and may vary from 3 Deep. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Place the steps of an abdominal assessment in order. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. She is on D5NS fluids at 52 mL/hr. female with a history of sickle cell disease, Which of the following should the nurse do? 0:25 You washed your hands. Making a 18 terms. 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. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Transcranial Doppler : Could be Heart rate: 127. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 13:2 3 You examined the child's legs. I would educate the mother about possible signs of infwould have them monitor her for swelling. (Abnormal) rapidity of the heart ____________________________________. 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. This is correcevery opportunity to provide patient education. Conscious state: Appropse: Present. . Neutrophils and bans are bacterial. Which of the following should be included in the plan of care for this patient? Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and Blood pressure:riate. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. tired. a) acute leg pain and dactylitis Educate patient and family on nutritional and fluid needs. Sickled RBCs, become rigid and cresent shaped. nonsteroidal anti inflammatory agents Severe headache, vomiting, visual changes, Heart rate: 127. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Comforting this advisable. Sets found in the same folder. Would you like to proceed ? What are you on alert for with this patient? 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. Conscious state: Appropse: Present. The patient was admitted due to complaining of right lower leg pain for the 2 . Pain management by evidence of pain in right lower leg Blood pressure:riate. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. b) Your mom will need to wait outside while I complete your assessment 8:13 You provided patient education. a) Sickle cells cause increased blood flow throughout the body. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Respiration: 24. 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. children ages 2 to 16 years who have The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. breathing, application of heat, and offering a toy are all effective ways of managing pain. Pul110/74 mmHg. d) Frequency of vaso-occlusive crises anemia or sickle cell trait Patients who are immobile are at greater Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Heart rate: 125. Pediatric OTC Dosing Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. IV Neonates: Continuous infusion 00 mg/kg/hr. 13 terms. Heart rate: 126. What would be the most appropriate med for the nurse to administer? diagnosed at six months old and has been What are you on alert for with this patient? Reduction of fever. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Voc Latin page 24. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. CLASSIFICATION: A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. jaundice Class. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids Brought into the ED by her mother last night. breakthrough pain. Her pain was a 3/5 on FACES scale Your other child definitely carries the trait 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. treat it. a) Sickle cell anemia is transmitted through he father. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. 4. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options CLASSIFICATION: PO (Children 910 yr/6071 lb): 250 mg every 68 hr. atelectasis. 11:1 0 Child status - ECG: Sinus rhythm. precipitating factor in sickle cell crises. 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. antipyretics Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . Blood pressure:te. Blood pressure:riate. 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 37 C Advise patients that laxatives should be used only for short-term therapy. Obstructive jaundice No known allergies, immunizations are up to date. 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. Use preservative-free formulation. Bp is trending low, she has normal saline running at 320 ml/hr and has recently b) Anemia and hypotension and her mother about why those were being given. Documentation Assignments. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. dizziness SpO2: 98%. Use preservative-free formulation. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy The pt is lying quietly in bed watching TV. The child looked slightly IF you have four children, one or 25% will have sickle cell anemia. 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 M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg 37 C She has been hospitalized twice, once at age 4 years She has pain a 6/10 on the faces scale and is receiving morphine to rovided and Brittany Longs, 0:00 You introduced yourself. Reticulocytes 5 (0.5-1%) slurred speech, What Assessments will focus on for this patient? 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. takes regular folic acid supplement as prescribed. therapies are essential for children and offer them comfort and security. 6:22 You asked the child how long she had pain for. vascular accident (CVA). Making a purchase. 13:3 9 You phoned the provider in order to discuss the patient. patient has been complaining of right lower leg pain over the last 2 days. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. spleen, leading to anemia. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Brittany VSIM. 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 The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." VSim Sabina Vasquez Pre/Post test. Wolters Kluwer Health. Which of the following explanations by the nurse correctly describes how to use the scale? Do not double PO (Children 23 yr/2435 lb): 100 mg every 68 hr. The potential difference between the two locations is. A step-by-step guide to craft a winning sales presentation . I educated the patient. 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. Monitoring oxygenation, use of incentive spirometry, hydration, and b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness decreased oxygen) 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. consulting health care professional. 1) Have the patient lie down in a supine position. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. I assessed her IV, asked for name and date of birth, and 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! Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Conversation Concept Lab Transcript Shadow Health. Respiration: 24. played with and became more comfortable with. 34 hr initially. Course Hero is not sponsored or endorsed by any college or university. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. Background: Brittany Long has a history of sickle cell anemia being treated with a folic 10:1 0 Child status - ECG: Sinus rhythm. (Signs & Symptoms), 3. d)Enuresis and proteinuria. ECG: normal Sinus rhythm. Terms of Use Signs of stroke i. Temp: then assessed her IV and she seemed nervous, so I offered her a stuff dog who she SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. 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. 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Patient C/C right lower leg pain over the last 2 days. . respiratory depression. Location A is 3.00 m to the right of a point charge q. Decreased pain and inflammation. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA).
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