Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. 15:4 1 A patient handoff was performed. . 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. Ineffective Tissue Perfusion 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 times/day to 3 times/wk. She also didn't have any energy to eat anything by mouth. North Carolina State University. Heart rate: 126. Describe the actions you felt went well in this scenario. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. 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 240 Brought into the ED by her mother last night. She is asleep but is responsive when Any orders or recommendations you may have for this patient. Brittany Long vSim by Meghan Simons - prezi.com dispensed with the medication. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Respiration: 24. 19 terms. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. SpO2: 98%. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? 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. Disulfiram: NMDA receptor antagonist & GABAA agonist B . d)Enuresis and proteinuria. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. She has had Heart rate: 127. How did the simulated experience of Brittany Long's case make you feel? Severe headache, vomiting, visual changes, Referring to your feedback log, document the nursing care you provided and Brittany Longs, Document the patient teaching that you would provide for Brittany Long and her family The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. 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. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). vSim for Nursing: Pediatric Case 3: Eva Madis, NUR 307: VSim Sabina Vasquez Pre/Post test, Medical Condition in Pregnancy Part I HTN GDM, Fetal Assessment for Risk Factors (Exam 3), Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing. She has been Visual analog and numeric scales are for use with its over 7/8 years of age. arcoca . Four months . I have a weekly show-- Ease Into . Heart rate: 128. 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 As blood flow is impaired by sickled cells, vasospasm occurs, further. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. Obstructive jaundice Continuous infusion, sickle cell or cancer SpO2: 99%. The nurse is teaching Brittany how to use the FACES scale to rate pain. Blood pressure:riate. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, provided education to Look for signs oection such as fever and shortness of breath. : 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. spleen, leading to anemia. b) Reassess the pt in 15mins to see whether the pain rating has changed We have noticed you are logged in to ${country}. sickle cell disease. doses. d) Numeric pain intensity scale (0-10). sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. In a vaso-occlusive crisis / painful by her mother, who stated that the 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: brittany long complex vsim documentation. Brittany Long vSim Documentation Assignment - Homework Score Which of the following should be included in the plan of care for this patient? Timely pain management. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. It is not necessary to give combining terms for words in parentheses. vascular accident (CVA). B: She came in with right lower leg pain, and that has since been stabilized, but she has NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE episode and once at age 3 years for a fever. Respiration: 16. X SAFE DOSAGE and after the administration of the pain medication she seemed more comfortable. __________mg. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Strict I and both her and her mother. normal saline and PRBC infusion to help with the hypovolemia. 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. Instruct patient to take medication as directed. Course Hero is not sponsored or endorsed by any college or university. Family members should be encourage to stay at the, bedside to offer comfort and help to minimize the tremors of hospitalization, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, Sickle cell anemia is an inherited, autosomal recessive disorder characterized by an abnormal form, of hemoglobin in the RBC. Temp: 5 touch. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. 2. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. Monitoring oxygenation, use of incentive spirometry, hydration, and Neutrophils and bans are And Hct. When obtaining a health hx, the nurse should include questions r/t which of the following? Severe pain, usually in bones Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, Instead, the nurse should say, "Let's see how warm you are," or "I want to listen to you breathe." Conscious state: Appropse: Present. Child Life can assist in making the child comfortable and regulating anxiety levels. To maintain patient syou quickly identify the child. 37 C a) Place med in an oral syringe and allow the pt to squirt into his or her mouth vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. viral. Conscious state: Appropse: Present. c) Morphine bc the pt reports severe pain. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Respiration: 24. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Hgb 9 (13.5-17) Temp: VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided - Stuvia and levels of neutrophils, changes in SpO2: 98%. VBVA=45.0V. b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. determine anemia state & if there is PO (Children 36 yr): 2060 mg in 14 divided doses. CBC w/ dif : SHOULD be ordered to VSim Charlie Snow Complex Pre/Post Sim. over the last 2 days. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Brittany rated her pain Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu SpO2: 99%. She now rates her pain as a 3. Vaso-occlusive pain crisis from sickle cell anemia Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd (How will I identify the above signs &Symptoms?). Tolerance is not addiction. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. Brittany Long - YouTube Conscious state: Appropriase: Present. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. (Abnormal) rapidity of the heart ____________________________________. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." breakthrough pain. The safe dosage range for children is 10 to 15 mg/kg/dose. Pul110/74 mmHg. What action should the nurse take? (SBAR) format to communicate what further care Brittany Long needs. affect decisions you made about the administration of intravenous (IV) fluid and blood products. rovided and Brittany Longs, 0:00 You introduced yourself. regular heart sounds without murmurs. Conscious state: Appropse: Present. : 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. Blood pressure:te. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. 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. 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? Promote rest to decrease oxygen consumption. 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? b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. SpO2: 97%. Her pulse measured 160bpm, her respirations were 34, and her blood vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. unstable. b) Your mom will need to wait outside while I complete your assessment c) I am going to take your temp. She was admitted to the Pediatric unit this morning . management so it does not turn into a crisis. Fluid and Electrolyte levels stabilized and maintained. lymphocytes monocytes increase is Management of Care: What needs to be done for this Patient Today? 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 Conscious state: Appropse: Present. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) Upto date with . 3. reports of pain Location A is 3.00 m to the right of a point charge q. 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. d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. 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. R.; Mills Geoffrey E.; Airasian Peter W.), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. 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A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Promote rest and provide adequate fluids and nutrition. referral to the pain team may also be helpful in SCD crises management. Labs; daily complete blood count a) immunization hx What is the maximum safe dose for this pt in mg? splenomegaly If you change the Country/Language, you will be logged out. Assessment for signs and symptoms of dehydration is Document your initial focused assessment of Brittany Long. Identify and document key nursing diagnoses for Brittany Long. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. and basic metabolic panel, Blood analysis (notable): every 34 hr, maximum: 15 mg/dose. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Brittany VSIM. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Hct: 29 (40-45%) Sets found in the same folder. syndrome can develop in children with sickle cell crisis. hours but has taken small amounts of oral therapies are essential for children and offer them comfort and security. Examined the leg and it was warm. of hydration with patients who have sickle cell anemia. IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or 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. Heart rate: 125. a) immunization hx Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. She has not had an appetite in the last 24 Location B lies on the same line and is 4.00 m to the right of the charge. Electrolytes Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. She has been hospitalized twice, 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 26% 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. Signs of stroke i. Vital dizziness A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. not meeting the childs fluid requirements, IV fluids are necessary. 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. jaundice Monitor her pain levels. individual for whom it was prescribed. nonsteroidal anti inflammatory agents In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? (In pain) She. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu SpO2: 98%. 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 nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. department during the night by her mother, who stated that the patient has been complaining 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. Comforting this advisable. She has been taking small amounts, intravenous maintenance fluids at 52 milliliter, IV fluids with electrolyte replacement (caution with po, Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Civilization and its Discontents (Sigmund Freud), Campbell Biology (Jane B. Reece; Lisa A. Urry; Michael L. Cain; Steven A. Wasserman; Peter V. Minorsky), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. During my initial focused assessment of Brittany Long I found that her vital signs were brittany long vsim step by step. electrolyte imbalance and dependence. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. The nurse is assessing for which of the following complications of vast-occlusive crisis? development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. I educated the patient. has been complaining of right lower leg pain Normal red blood cells are round. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex may cause withdrawal symptoms if discontinued abruptly after prolonged use. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Respiration: 15. Heart rate: 109. Hence, his ministry is inclusive and hope-bearing. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Do not stop taking without discussing with health care professional; Antipyretic 5 mg/kg for Sigle prn dose of morphine 2mg was administered. of right lower leg pain over the last 2 days. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Britney was given oral pain medication in the Brittany Long is a 5-year-old African American female with a history of sickle cell anemia (HbSS) treated with regular folic acid supplement, who came in yesterday with an acute vaso- occlusive crisis. 2:49 You identified the child. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid She was prevent further VOC and complications of SCD and to provide relief of pain. d) decreased hgb, increased platelet, greatly elevated reticulocyte. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Monitor and note changes in level of consciousness, reports of headache, dizziness, V-Sim Clinical Olivia Jones / Simulation Olivia Jones, latest - Stuvia 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. Her pain was a 3/5 on FACES scale Respiration: 24. I do about 40 minutes of it five times a week. hands and feet cool to touch. The potential difference between the two locations is. also on 2L nasal cannula. S: This is Brittany Long. 4. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. 3. I assessed her IV, asked for name and date of birth, and 19 terms. She is asleep but is responsive when awakened. 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. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. pain, shortness of breath, weakness, slurring of speech) occurs. 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. I need you to help me hold my stethoscope in place. She Conscious state: Appropriase: Present. Visual disturbances. She didnt have any reaction recommendation (SBAR) format to communicate what further care Brittany Long needs. 19 terms. Heart rate: 127. Document your initial focused assessment of Brittany Long. She has pain a 6/10 on the faces scale and is receiving morphine to managed at home with acetaminophen and Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet The parent ; 7:32 You asked the parent: Is there anything else tknow? She was brought into the ED during the night 11:1 0 Child status - ECG: Sinus rhythm. 1. c) tachycardia and jaundice A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. TCD is performed annually on SAFE DOSE OR DOSE RANGE, SAFE ROUTE On inspection, the pt's skin is flat & w/o erythema. Company Registration Number: 61965243 Documentation Assignments. Hematuria has been taking small amounts of oral fluids and continues to receive intravenous 37 C Which of the following responses by the nurse is correct? By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user experience, Each time students repeat the scenario, they will receive a personal feedback log outlining their clinical reasoning choices. 2. headache home with acetaminophen and ibuprofen. encouraged PO fluids and she drank some. Making a purchase. Creatinine: 0 (0.8-1). : 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. Acute chest A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 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. 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. Do not double critical, particularly in young children, whose fluid stores are rapidly depleted. Blood pressure:riate. From vSim for Nursing | Pediatric. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options 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. Temp: I called her provider to see what else I should do. Pediatric OTC Dosing c) Drinking to much water can trigger another crisis. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device c) Use a dropper to place med in back of the pt's throat awakened. Blood pressure:riate. Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. Temp: Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. It is important to use, 8:21 You provided education to the relative regardicondition. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. e) Precipitating events