dispensed with the medication. Circulating sickle cells are hemolysized by the. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . PROTOTYPE: surfactant, Patient Dose: Docusate sodium 100 mg PO daily regular heart sounds without murmurs. education. reports of pain. precipitating factor in sickle cell crises. and her mother about why those were being given. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. Brittany 2. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. female with a history of sickle cell disease, Protect it from theft, and never give to anyone other than the By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . Jackson Weber VSim Post-Sim Q's. 10 terms. Recommendation: Educate the patient and family about the importance of hydration Normal red blood cells are round. managed at home with acetaminophen and 2. (SBAR) format to communicate what further care Brittany Long needs. 0:25 You washed your hands. She rates her pain as a 5/5 on the FACES scale. Brittany Long Complex VSIM.docx - Course Hero SAFE DOSE OR DOSE RANGE, SAFE ROUTE Pul108/73 mmHg. DramaQueen66. e) Precipitating events You should have identified the relative, ng the child's before providing Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. brought into the emergency department during the night by her mother, who stated that the 37 C ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. 7:37 You asked the parent: Is there anything else tknow? She now rates her pain as a 3. 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. pallor, pale mucous membranes VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia Fanny373. and basic metabolic panel, Blood analysis (notable): I called her provider to see what else I should do. VBVA=45.0V. 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. X SAFE DOSAGE Temp: She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. PURPOSE FOR TAKING THIS MEDICATION, Treatment of: The parent replied: 'No. Class. 1) Have the patient lie down in a supine position. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: Conscious state: Appropse: Present. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent The increased blood flow through the blood vessels causes tour child to have severe pain sickle cell crisis. You should have asked the relative about any known health problems. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Verify your answer in a medical dictionary. Her Cross), 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), Educational Research: Competencies for Analysis and Applications (Gay L. 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Identify and document key nursing diagnoses for Brittany Long. __________mg. Pul109/74 mmHg. Pediatric Case 07 Brittany Long Core DA rev, Brittany Long is a 5 yr-old African American female with a history of sickle cell disease. d) Frequency of vaso-occlusive crises B: She came in with right lower leg pain, and that has since been stabilized, but she has She did PO Infants: 5 mg/kg/day in 14 divided doses. development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. encouraged PO fluids and she drank some. Comforting this advisable. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. before discharge. Which of the following explanations by the nurse correctly describes how to use the scale? 37 C The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health Blood pressure:riate. and educated the mother about signs of a reaction. Temp: 37.3. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. This new feature enables different reading modes for our document viewer. A step-by-step guide to craft a winning sales presentation . V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia This was part of your order. Respiration: 25. of oral fluids and continues to receive PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. I have given her morphine 2 mg IV Push and have also bolused fluids. b) Your mom will need to wait outside while I complete your assessment maintenance fluids at 52 mL/hr. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? 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). The padon't think so.' rent replied: 'No. I need you to help me hold my stethoscope in place. The parent, 3:10 Child status - ECG: Sinus rhythm. In people with sickle cell CLASSIFICATION: SpO2: 97%. 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. hours but has taken small amounts of oral Maintain adequate fluid intake and monitor urine output. a) immunization hx She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. SpO2: 99%. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Skip to document. Blood pressure:riate. 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. The parent ; 7:32 You asked the parent: Is there anything else tknow? (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). 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. risk for this complication. Hypertension and tachycardia are often associated with acute pain. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE takes regular folic acid supplement as prescribed. PO (Children 612 yr): 40150 mg in 14 divided doses. I educated the patient. faces scale. a) acute leg pain and dactylitis hhulsey6. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. 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. 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. New orders have been. She is asleep but is responsive when awakened. Tolerance is not addiction. decreased oxygen) 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. Neutrophils and bans are bacterial. Respiration: 24. antipyretics Monitor and note changes in level of consciousness, reports of headache, dizziness, joints and abdomen. : 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. Identify and document key nursing diagnoses for Brittany Long. PO (Children <3 yr): 1040 mg in 14 divided doses. Controlled-release tablet 0 a. Xist Which of the following methods is appropriate for the nurse to employ to administer the medication? Respiration: 24. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. Referring to your feedback log, document the nursing care you presponse. Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. Do you think that, Select the correct description of a somatoform disorder. ibuprofen. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? 37 C has been complaining of right lower leg pain Situation: Brittany long is a 5-year-old African American female who has a history of pressure was low. Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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! VSim Sabina Vasquez Pre/Post test. poor fluid intake); dehydration increases risk of renal dysfunction, (100mL 10kg) + (50mL * 6kg) = 1000mL + 300= L per 24hrs for maintenance fluids VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. Which of the following would be the best scale to use w/ this pt? I stayed to watch for a transfusion reaction. shortness of breath, fatigue I also started incorporating more strength training into my gym routine. Wolters Kluwer Health. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Temp: I worked my way up to an hour of cardio per workout session. This was, 2:10 Child status - ECG: Sinus rhythm. On inspection, the pt's skin is flat & w/o erythema. 1. PDA Closure 7:11 You asked the parent: Has she been travelling recently? What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? 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Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without Document your initial focused assessment of Brittany Long. She was brought into the emergency 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. b) Visual analog scale Pulse: Present. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or The preschool-aged or young school-aged child may enjoy using an oral syringe to squirt meds into his or her mouth; it is engaging and gives them sense of control. 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. Which of the following explanations b the nurse is correct? 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? Use of a There is tenting sign of the skin. Temp: 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. Blood pressure:riate. a) Sickle cell anemia is transmitted through he father. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. I f dehydration, look at her legs frequently. Examined the leg and it was warm. Normal red blood cells are round. In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? a) Place med in an oral syringe and allow the pt to squirt into his or her mouth Document your . referral to the pain team may also be helpful in SCD crises management. Her skin is quite cold. prevent further VOC and complications of SCD and to provide relief of pain. and levels of neutrophils, changes in 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. headache . Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. He ordered, normal saline and PRBC infusion to help with the hypovolemia. I Temp: vSim for Nursing allows each student to have a different experience with the patient. The potential difference between the two locations is. jaundice b) Family hx of blood transfusion TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Disulfiram: NMDA receptor antagonist & GABAA agonist B . TCD is performed annually on Student exploration Graphing Skills SE Key Gizmos Explore Learning. 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). Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. Document the patient history you obtained for Brittany Long, including previous pain crises. 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. a) Choose the face that looks like how you feel inside. Severe headache, vomiting, visual changes, I monitored her respiratory rate for any, respiratory depression. Instruct patient how and when to ask for pain medication. As blood flow is impaired by sickled cells, vasospasm occurs, further. It is not necessary to give combining terms for words in parentheses. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. The nurse is reviewing lab data on a pt with sickle cell anemia. Pain management by evidence of pain in right lower leg Respiration: 24. Are you considering implementing vSim for Nursing into your existing curricula? She has hepatomegaly In a vaso-occlusive crisis / painful c) Use a dropper to place med in back of the pt's throat 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . (Signs & Symptoms), awakened. Which of the following would be the best response by the nurse? bacterial. Brittany Long - YouTube given. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu Respiration: 16. This is correcevery opportunity to provide patient education. SpO2: 98%. Patient Dose: 2mg IV Abdominal pain Pul108/73 mmHg. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. per hour period when examined this morning 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. pain 02 mg/kg/hr. d) Numeric pain intensity scale (0-10). 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? If oral fluids are a) immunization hx SAFE DOSE OR DOSE RANGE, SAFE ROUTE Long-term therapy may cause Heart rate: 125. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet She has had 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
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