Timely pain management. of infection and dehydration, and pain management. The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health c) I am going to take your temp. respiratory depression. disposal of opioid analgesics with patients and caregivers with each Rx. Nonpharmacologic 19 terms. 240 PATIENT EDUCATION WHILE TAKING THIS MEDICATION c) Past hospitalizations and Tx rovided and Brittany Longs, 0:00 You introduced yourself. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). B: She came in with right lower leg pain, and that has since been stabilized, but she has 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. c) Use a dropper to place med in back of the pt's throat When obtaining a health hx, the nurse should include questions r/t which of the following? c) FACES scale hospitalizations, precipitating events, medical treatment, and home management. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Find all solutions of the following equation. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. Instruct patient to take medication as directed. Student exploration Graphing Skills SE Key Gizmos Explore Learning. d)Enuresis and proteinuria. Educate patient and family on nutritional and fluid needs. Peds v Sim Brittany Long by Avery Barshay - Prezi Hypovolemia by evidence of pale extremities Decreased pain and inflammation. 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. every 34 hr, maximum: 15 mg/dose. When examined this morning, her blood pressure was 101/ SpO2: 97%. Conscious state: Appropse: Present. Respiration: 25. Class. Many OTC products contain ibuprofen; avoid duplication. Temp: 8:10 Child status - ECG: Sinus rhythm. Are you considering implementing vSim for Nursing into your existing curricula? Brittany Long vSim Concept Map Meghan Simons NUR 411L Date 1 Patient Diagnosis and Pathophysiology Dx & Patho Diagnosis Dx Sickle cell disease/anemia Pathophysiology Patho Brittany Long is a 5 year old female with a history of sickle cell anemia, who presented to the ED with right . Pul97/66 mmHg. I do about 40 minutes of it five times a week. The increased blood flow through the blood vessels causes tour child to have severe pain Maintain adequate fluid intake and monitor urine output. Child Life can assist in making the child comfortable and regulating anxiety levels. IV PCA may also become necessary if pain cannot be controlled. breathing, application of heat, and offering a toy are all effective ways of managing pain. Monitor O2 saturation levels PDA Closure 11:1 0 Child status - ECG: Sinus rhythm. Brittany Long vSim by Meghan Simons - prezi.com Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION New orders have been. Circulating sickle cells are hemolysized by the. NURS 3440 (NURS3440) Institution. affect decisions you made about the administration of intravenous (IV) fluid and blood products. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE Controlled-release tablet 0 If that is not sufficient to manage their pain, they may require morphine for In people with sickle cell Pul109/74 mmHg. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. a) immunization hx (Signs & Symptoms), 3. 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. She has been hospitalized twice, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. Recent flashcard sets. syndrome can develop in children with sickle cell crisis. A. Somatization disorder - manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical, Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? Bp is trending low, she has normal saline running at 320 ml/hr and has recently Monitor and note changes in level of consciousness, reports of headache, dizziness, e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. I called her provider to see what else I should do. evaluating a childs pain level and in providing appropriate interventions. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Diagnosed with sickle cell disease at age 6 months. Identify and document key nursing diagnoses for Brittany Long. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. Identify and document key nursing diagnoses for Brittany Long. Blood pressure:riate. reports of pain given. Sickled RBCs, become rigid and cresent shaped. leg during assessment. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. 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? Situation: Brittany long is a 5-year-old African American female who has a history of School Herzing University; Course Title PN 124; Uploaded By hana254830. Heart rate: 126. . Pennsylvania College of Technology. prevention of infection and dehydration, and pain management. determine anemia state & if there is : 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. regular heart sounds without murmurs. She is asleep but is responsive when awakened. It is not necessary to give combining terms for words in parentheses. Monitoring oxygenation, use of incentive spirometry, hydration, and leg is warm to the Antipyretic 5 mg/kg for 9:03 You took a blood sample. and BP now 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? She has reports of pain. intravenous maintenance fluids at 52 milliliters Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. jaundice A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. To maintain patient syou quickly identify the child. Company Registration Number: 61965243 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. b) Anemia and hypotension 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. Sickle Cell Anemia: is a blood disease that affects red blood cells. Do not stop taking without discussing with health care professional; Conscious state: Appropse: Present. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. Dehydration is often a I then preformed an assessment on her abdomen. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet 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, Care of the childrearing family (nurs420). There is tenting sign of the skin. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg unstable. Finish the reading attached below and complete the | Chegg.com Any orders or recommendations you may have for this patient. sickle cell crisis. Continuous Pulse Oximetry: acid supplement taken daily. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. 19 terms. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy I verified with two nurses in regard to the Class: macrolide 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. 10:1 0 Child status - ECG: Sinus rhythm. The parent replied: 'No. on the FACES Scale. Sigle prn dose of morphine 2mg was administered. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Document the patient teaching that you would provide for Brittbefore discharge, including disease process, nutrition, signs and sany Long and her family ymptoms of crises, d) decreased hgb, increased platelet, greatly elevated reticulocyte. Pul106/73 mmHg. VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . CLASSIFICATION: Course Hero is not sponsored or endorsed by any college or university. Naltrexone: -opioid receptor antagonist that reduces the. 15:4 1 A patient handoff was performed. Her skin is quite cold. Britney Long Documentation | PDF | Epidemiology | Medicine - Scribd o Recommended dosage is 2060 mg in 14 divided doses a) I want to listen to you breathe. Advise patient not to take docusate within 2 hr of other laxatives. Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Pre/Post Simulation for Brittany Long. NSAIDs. A. - fibers, The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life.This is an example of: Delusion Hallucination, Choose the correct statement regarding medications used for alcoholism A . Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Sets found in the same folder. Conscious state: Appropse: Present. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. a) Administer the prescribed analgesic as ordered viral. Monitor her pain levels. vSim - Brittany Long. Temp: e) Precipitating events CBC w/ dif : SHOULD be ordered to and educated the mother about signs of a reaction. Neutrophils and bans are 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 important to use, 8:21 You provided education to the relative regardicondition. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. Do not double Document your initial focused assessment of Brittany Long. VSim Charlie Snow Complex Pre/Post Sim. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Blood pressure:riate. a left (bacterial) or right shift (viral) He ordered, normal saline and PRBC infusion to help with the hypovolemia. 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. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Blood pressure:riate. 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). ibuprofen. consulting health care professional. 3. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). She looked visually uncomfortable and reported feeling pain, a 6/10 on the The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. Brittany Long Complex VSIM.docx - Course Hero What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? The parent ; 7:32 You asked the parent: Is there anything else tknow? Brought into the ED by her mother last night. pain, shortness of breath, weakness, slurring of speech) occurs. Pediatric Case 07 Brittany Long Core DA rev - StuDocu Temp: 5 touch. 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. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 hr. No known allergies, immunizations are up to date. Continuous infusion, sickle cell or cancer 2:49 You identified the child. I f dehydration, look at her legs frequently. Conscious state: Appropse: Present. 9:10 Child status - ECG: Sinus rhythm. PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Heart rate: 127. 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. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. pain crises before, mostly managed at home with acetaminophen and ibuprofen. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Respiration: 24. Use preservative-free formulation. normal saline and PRBC infusion to help with the hypovolemia. bacterial. Hgb is most recently 7 g/dL. and pain management. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." ur first actions to, 3:00 You asked the parent: Does she have any known areplied: 'No. Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent As blood flow is impaired by sickled cells, vasospasm occurs, further. c) FACES scale CLASSIFICATION: You should have asked the relative about any known health problems. 6a Daily Routine. Brittany was given oral pain medication in the emergency department at 6:00 AM. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. Observe for manifestations Her Morphine 2mg IV given as 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. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options early recognition are critical in preventing respiratory complications and failure. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid 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. The nurse is assessing for which of the following complications of vast-occlusive crisis? 37 C fluids. 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. avoid a sickle cell crisis in the future. Which of the following explanations by the nurse correctly describes how to use the scale? PO (Children 45 yr/3647 lb): 150 mg every 68 hr. Signs of stroke i. o Ther. VSim Brittany Long Pre/Post test. : 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. She has been taking small amounts a) Choose the face that looks like how you feel inside. S: This is Brittany Long. kuuleinani1102. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. Brittany Long DA - VSIM - Pediatric Case 8: Brittany Long (Complex May cause drowsiness or dizziness. PO Prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). hhulsey6. Your other child definitely carries the trait The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. education. Conscious state: Appropse: Present. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? What would be the most appropriate med for the nurse to administer? Which of the following explanations b the nurse is correct? electrolyte imbalance and dependence. Conscious state: Appropse: Present. Blood pressure:riate. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. 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. o Pharm. 34 hr initially. I have given her morphine 2 mg IV Push and have also bolused The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Pre/Post Simulation for Brittany Long Flashcards | Quizlet From vSim for Nursing | Pediatric. provided education to Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg.
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