13:2 3 You examined the child's legs. bacterial. Examined the leg and it was warm. Pul110/74 mmHg. Educate patient and family on nutritional and fluid needs. o Pharm. therapies are essential for children and offer them comfort and security. Class. intake (68 full glasses/day), and increasing mobility. 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. c) FACES scale ood or had a reaction to a. brittany long complex vsim documentation. Swollen joints, hands and feet Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. Temp: 37.3. Look for signs oection such as fever and shortness of breath. 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. Temp: development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. VSim Sabina Vasquez Pre/Post test. She is on D5NS fluids at 52 mL/hr. 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. Would you like to proceed ? Temp: b) Family hx of blood transfusion I completed a set of vitals, which were, HR: 159, Blood pressure: 99/77 mmHg, RR: 34, SpO2: affect decisions you made about the administration of intravenous (IV) fluid and blood products. leg is warm to the She has had pain crises before, mostly managed at 0 mg/kg every 12 hr. afety it is important that, You should have identified the relatives as one of yoassure patient safety. d) decreased hgb, increased platelet, greatly elevated reticulocyte. 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. vSim - Brittany Long. 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. reports of pain. 18 terms. Do your children have different fathers? Pediatric Case 08 Brittany Long Complex DA - StuDocu Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. vSim for Nursing allows each student to have a different experience with the patient. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . prescribed was given for her pain. The parent replied: 'No. given. Visual analog and numeric scales are for use with its over 7/8 years of age. Do not double and after the administration of the pain medication she seemed more comfortable. arcoca . Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. You must be logged in to submit this form. 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Patients who are immobile are at greater Bandage is clean dry and intact , infusing as expected, PATIENTS DOSE: 52*24 = 1248mL WNL SAFE DOSAGE [should probably be higher]. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). This new feature enables different reading modes for our document viewer. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Situation: Brittany long is a 5-year-old African American female who has a history of sickle cell anemia, she came into the hospital yesterday suffering from a sickle . a) acute leg pain and dactylitis Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. a) Sickle cells cause increased blood flow throughout the body. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. I called her provider to see what else I should do. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. Many OTC products contain ibuprofen; avoid duplication. 0:25 You washed your hands. The spleen is enlarged, Monitor O2 saturation levels Assessment for signs and symptoms of dehydration is not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 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. Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. Pediatric OTC Dosing of oral fluids and continues to receive She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. as a 5 on the FACES Scale and did not want anyone to touch her leg during assessment. (Signs & Symptoms), 3. Document your handoff report in the situation-background-assessment- 19 terms. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. Nonpharmacologic (Abnormal) rapidity of the heart ____________________________________. Place the steps of an abdominal assessment in order. Respiration: 25. Sickle Cell Anemia: is a blood disease that affects red blood cells. Sickled RBCs, become rigid and cresent shaped. 7:37 You asked the parent: Is there anything else tknow? A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. 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. dizziness PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. I monitored her respiratory rate for any, respiratory depression. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options 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. Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . flow and detect the risk for cerebral Heart rate: 109. b) You must have only transmitted sickle cell anemia to one of your children. Morphine 2mg IV given as regular heart sounds without murmurs. Advise patients that laxatives should be used only for short-term therapy. Brittany Long vSim Documentation Assignment - Homework Score Pre/Post Simulation for Brittany Long Flashcards | Quizlet 19 terms. The nurse is assessing for which of the following complications of vast-occlusive crisis? Respiration: 16. I verified with two nurses in regard to the I do about 40 minutes of it five times a week. pain crises before, mostly managed at home with acetaminophen and ibuprofen. 4. Wolters Kluwer Health. Any orders or recommendations you may have for this patient. a) FLACC scale critical, particularly in young children, whose fluid stores are rapidly depleted. Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. and levels of neutrophils, changes in brittany vsim | Write my Essay | Assignment Help She now rates her pain as a 3. priapism pain 02 mg/kg/hr. o Pharmacologic: opioid agonists Do not stop taking without discussing with health care professional; B: She came in with right lower leg pain, and that has since been stabilized, but she has PROTOTYPE: Morphine. Heart rate: 128. IV Neonates: Continuous infusion 00 mg/kg/hr. her pain as a three. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. not meeting the childs fluid requirements, IV fluids are necessary. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. She has been hospitalized twice, once at age 4 years pallor, pale mucous membranes maintenance fluids at 52 mL/hr. Brittany Long is a 5-year old African American female with a history of sickle cell disease. o Ther. Conscious state: Appropse: Present. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Store out of sight and reach of children, and in a location not accessible by others. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Respiration: 15. Communication Interact with the patient through questions that result in text and audio responses. NS and PRBCs. Normal red blood cells are round. Temp: rovided and Brittany Longs, 0:00 You introduced yourself. Initial focus assessment was the patients pain and location. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. 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. Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Creatinine: 0 (0.8-1). Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. hours but has taken small amounts of oral 2. line infusion rate to 52. of right lower leg pain over the last 2 days. Hgb is most recently 7 g/dL. 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! of hydration with patients who have sickle cell anemia. has been complaining of right lower leg pain Decreased pain and inflammation. 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. The breath sounds are clear and equal bilaterally. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Conscious state: Appropriate. 3. Hgb 9 (13.5-17) c) Morphine bc the pt reports severe pain. Over time, the The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. abdomen is generally tender. vascular accident (CVA). Finish the reading attached below and complete the | Chegg.com per hour period when examined this morning over the last 2 days. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. temperature was 37 Celsius she now rates Which of the following explanations b the nurse is correct? Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). She didnt have any reaction e) Precipitating events You should have identified the relative, ng the child's before providing