played with and became more comfortable with. He ordered, normal saline and PRBC infusion to help with the hypovolemia. c) Morphine bc the pt reports severe pain. Severe pain, usually in bones b) You must have only transmitted sickle cell anemia to one of your children. 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. Course Hero is not sponsored or endorsed by any college or university. Pulmonary edema. children ages 2 to 16 years who have Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Her 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. I worked my way up to an hour of cardio per workout session. Use preservative-free formulation. Blood pressure:riate. regular heart sounds without murmurs. line infusion rate to 52. 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. After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? (Signs & Symptoms), awakened. I then preformed an assessment on her abdomen. 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When examined this morning, her blood pressure was 101/ 4. a) I want to listen to you breathe. New orders have been Patient Dose: 2mg IV A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. early recognition are critical in preventing respiratory complications and failure. Assess dehydration status via CBC, Urinalysis and strict I/O. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Deep. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. e) Precipitating events. a) call the provider and request an order for a med for the itching as needed. Continuous infusion, sickle cell or cancer 13 terms. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. May cause drowsiness or dizziness. Jackson Weber VSim Post-Sim Q's. 10 terms. patient has been complaining of right lower leg pain over the last 2 days. Pain level controlled and maintained, avoiding. (Abnormal) rapidity of the heart ____________________________________. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Promote rest to decrease oxygen consumption. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. Hgb is most recently 7 g/dL. by her mother, who stated that the patient 2400 mg/day, whichever is less). (SBAR) format to communicate what further care Brittany Long needs. Verify your answer in a medical dictionary. 0:10 Child status - ECG: Sinus rhythm. 19 terms. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Recent flashcard sets . The. Transcranial Doppler : Could be Many OTC products contain ibuprofen; avoid duplication. and BP now ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. Conscious state: Appropse: Present. Hematuria 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. both her and her mother. d)Enuresis and proteinuria. and educated the mother about signs of a reaction. diagnosed at six months old and has been c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Heart rate: 128. SpO2: 99%. The padon&apos;t think so.&apos; rent replied: &apos;No. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Company Registration Number: 61965243 vSim - Brittany Long. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Strict I and PATIENT EDUCATION WHILE TAKING THIS MEDICATION 7:03 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? 3. Class. Monitor her 02 sat and keep above 94%. of right lower leg pain over the last 2 days. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I temperature was 37 Celsius she now rates leg during assessment. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. Hypovolemia by evidence of pale extremities of infection and dehydration, and pain management. Document your initial focused assessment of Brittany Long. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. 37 C 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. d) Anemia and hypotension. and the abdomen is generally tender. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Children should never be force to change into a gown. CLASSIFICATION: Administer oxygen as prescribed if hypoxia is present. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. Temp: Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Britney rated her pain as a 5 on the faces 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. (In pain) She replied: 6:49 You asked the parent: When the problems starte&apos;A few days ago.&apos; d. The parent replied: 6:54 You asked the parent: Has she had fever? Pediatric Case 7: Brittany Long (Core) 1. Skip to document. b) Reassess the pt in 15mins to see whether the pain rating has changed blood and then administered it. Temp: Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. I monitored her respiratory rate for any 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. She has been hospitalized twice, vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) d) Frequency of vaso-occlusive crises Signs of stroke i. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. PO (Children <3 yr): 1040 mg in 14 divided doses. Course Hero is not sponsored or endorsed by any college or university. : 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. Family history of sickle cell Advise patient that morphine is a drug with known abuse potential. She was admitted to the Pediatric unit this morning . vSim - Brittany Long. She has had pain crises before, mostly management so it does not turn into a crisis. Pediatric Case : Brittany Long. 0:25 You washed your hands. 2. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Respiration: 24. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). jaundice Brittany was given oral pain medication in the emergency department at 6:00 AM. 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Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options 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. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she breathing, application of heat, and offering a toy are all effective ways of managing pain. Which of the following should the nurse do? Normal bowel habits are variable and may vary from 3 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. PROTOTYPE: Aspirin The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Brittany Long (Core) - Sickle Cell Anemia with Acute Pain Crisis. Heart rate: 127. nonopioid analgesics 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. 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The increased blood flow through the blood vessels causes tour child to have severe pain Before discharging Brittany Long and her family, I would educate them on how to also on 2L nasal cannula. scale and did not want anyone to touch her I NS and PRBCs. had a sudden increase in pain in her abdomen. Pulse: Present. Decreased pain and inflammation. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? I verified with two nurses in regard to the hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." a. Xist 1:34 You obtained legal consent from the child&apos;reasonable. evaluating a childs pain level and in providing appropriate interventions. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1. Respiration: 25. 19 terms. 1. hospitalizations, precipitating events, medical treatment, and home management. doses. Monitor and note changes in level of consciousness, reports of headache, dizziness, Communication Interact with the patient through questions that result in text and audio responses. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. She looked visually uncomfortable and reported feeling pain, a 6/10 on the department during the night by her mother, who stated that the patient has been complaining She has had I don&apos;t think so.&apos; llergies? 37 C, 6:13 You asked the child if anything made the pain breplied: &apos;No&apos; etter. dispensed with the medication. brought into the emergency department during the night by her mother, who stated that the She was Conscious state: Appropse: Present. s relative. risk for this complication. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. a) immunization hx It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. home with acetaminophen and ibuprofen. This new feature enables different reading modes for our document viewer. 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. A heart rate of 86 bpm and temperature of 37.0C are normal findings. . PO (Children 612 yr): 40150 mg in 14 divided doses. 8:10 Child status - ECG: Sinus rhythm. I would also educate on the importance Assessment for signs and symptoms of dehydration is The nursing care for Brittany Long began with obtaining a set of vitals. Initial focus assessment was the patients pain and location. d) Numeric pain intensity scale (0-10). a) I want to listen to you breathe. S: This is Brittany Long. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F).