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VSim Sabina Vasquez Pre/Post test. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? A step-by-step guide to craft a winning sales presentation . Conscious state: Appropriase: Present. I f dehydration, look at her legs frequently. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: 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. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. episode and once at age 3 years for a fever. 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 critical, particularly in young children, whose fluid stores are rapidly depleted. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. and the abdomen is generally tender. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. 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. Neutrophils and bans are bacterial. 2400 mg/day, whichever is less). Hypertension and tachycardia are often associated with acute pain. a left (bacterial) or right shift (viral) Respiration: 24. 2. pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. A step-by-step guide to craft a winning sales presentation . Would you like to proceed ? Promote rest and provide adequate fluids and nutrition. PATIENT EDUCATION WHILE TAKING THIS MEDICATION pain, shortness of breath, weakness, slurring of speech) occurs. Assess patient and caregiver knowledge of how to avoid crisis. risk for this complication. a) immunization hx 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? The breath sounds are clear and equal bilaterally. times/day to 3 times/wk. Verify your answer in a medical dictionary. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. individual for whom it was prescribed. Which of the following explanations b the nurse is correct? I don't thhat you think we should ink so.' 7:47 You offered the child a toy. PATIENT EDUCATION WHILE TAKING THIS MEDICATION She also didn't have any energy to eat anything by mouth. Respiration: 24. Britney long is a 5 year old African American Instruct patient how and when to ask for pain medication. Brittany Long was diagnosed with sickle cell disease at 6 months old. c) Ask the parent whether the pt is hurting vSim for Nursing Pediatric | Laerdal Medical Document the patient history you obtained for Brittany Long, including previous pain crises. SpO2: 99%. What are you on alert for with this patient? X SAFE DOSAGE Her pain was a 3/5 on FACES scale Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. Os, Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 1. Normal red blood cells are round. Management of Care: What needs to be done for this Patient Today? diagnosed at six months old and has been 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. brought into the emergency department during the night by her mother, who stated that the CLASSIFICATION: Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Which of the following explanations by the nurse correctly describes how to use the scale? Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). This was not part of your orders here. 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. Heart rate: 125. Educate patient and family on nutritional and fluid needs. Britney was given oral pain medication in the Timely pain management. Conscious state: Appropse: Present. Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. 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. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, From vSim for Nursing | Pediatric. This was, 2:10 Child status - ECG: Sinus rhythm. She has pain a 6/10 on the faces scale and is receiving morphine to Heart rate: 127. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. CBC due Q 4 hours. flow and detect the risk for cerebral Voc Latin page 24. 240 and basic metabolic panel, Blood analysis (notable): Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device 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. of hydration with patients who have sickle cell anemia. Morphine 2mg IV given as Observe for manifestations Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Brittany Long SBAR.docx - vSim ISBAR ACTIVITY INTRODUCTION She has gained 3 pounds since prenatal visit 1 week ago. has been complaining of right lower leg pain Blood pressure:riate. Initial focus assessment was the patients pain and location. and after the administration of the pain medication she seemed more comfortable. Severe pain, usually in bones Document your initial focused assessment of Brittany Long. Temp: Morphine 2mg IV. Hct: 29 (40-45%) e) Precipitating events She is a 5-year-old female with a history of sickle cell anemia. Bp is trending low, she has normal saline running at 320 ml/hr and has recently Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. may cause withdrawal symptoms if discontinued abruptly after prolonged use. Her pulse measured 160bpm, her respirations were 34, and her blood a) immunization hx 1. The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health She also did n't have any energy to eat anything by mouth . vascular accident (CVA). Course Hero is not sponsored or endorsed by any college or university. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? She didnt have any reaction respiratory depression. The pt received morphine sulfate IV 1 hr ago for severe pain and is awake, alert, and complaining of generalized itching. 15:1 0 Child status - ECG: Sinus rhythm. Pediatric Case 08 Brittany Long Complex DA - StuDocu Temp: SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. a) Acute leg pain and dactylitis. If oral fluids are every 34 hr, maximum: 15 mg/dose. spleen, leading to anemia. headache She is on D5NS fluids at 52 mL/hr. d) Sickle cell anemia is transmitted through the mother. given. Take note of leg during assessment. Conscious state: Appropse: Present. of infection and dehydration, and pain management. PO Infants: 5 mg/kg/day in 14 divided doses. 2. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Course Hero is not sponsored or endorsed by any college or university. There is tenting sign of the skin. home with acetaminophen and ibuprofen. Recommendation: Educate the patient and family about the importance of hydration The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. She did e) Precipitating events. He ordered encouraging fluids, she kept drinking as I gave her fluids. o Pharm. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? NSAIDs. Advise patients that laxatives should be used only for short-term therapy. ibuprofen. 20 terms. a) acute leg pain and dactylitis in her right lower legs. Look for signs oection such as fever and shortness of breath. Vsim Brittany Long Complex (Pre/Post) Flashcards | Quizlet Referring to your feedback log, document the nursing care you provided and Brittany Long. Brittany Long Core- vSim.docx - Brittany Long Pediatric pallor, pale mucous membranes Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. c) Morphine bc the pt reports severe pain. Adaptive, interactive virtual simulations with integrated curriculum resources and personalized feedback provide a full simulation learning experience for every student to promote confidence and competence in patient-centered care. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Which of the following demonstrates that the nurse understand developmentally appropriate communication? NS and PRBCs. Neutrophils and bans are red blood cells become rigid and shaped like crescent moons or sickles. Labs; daily complete blood count SpO2: 98%. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." 13 terms. On inspection, the pt's skin is flat & w/o erythema. SpO2: 99%. 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: 126. Hgb 9 (13.5-17) Diagnosed with sickle cell disease at age 6 months. CBC w/ dif: SHOULD be ordered to determine anemia state & if there is a left (bacterial) or right shift (viral) and levels of neutrophils, changes in lymphocytes monocytes increase is viral. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. Protect it from theft, and never give to anyone other than the Transcranial Doppler : Could be Heart rate: 109. Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . Heart rate: 126. Conscious state: Appropse: Present. used to assess Intercranial vascular School Herzing University; Course Title PN 124; Uploaded By hana254830. I Impaired Gas Exchange Temp: 5 touch. I need you to help me hold my stethoscope in place. Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Cross), 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), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. 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Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. Situation: Brittany long is a 5-year-old African American female who has a history of Student exploration Graphing Skills SE Key Gizmos Explore Learning. 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. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. PO (Children 612 yr): 40150 mg in 14 divided doses. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. The safe dosage range for children is 10 to 15 mg/kg/dose. What action should the nurse take? atelectasis. 2:49 You identified the child. Wolters Kluwer Health. greenstickynotes. New orders have been Which of the following would be the best response by the nurse? vSim for Nursing Maternity and Pediatric - Laerdal Medical 15 x 16 = 240. intake (68 full glasses/day), and increasing mobility. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth 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). c) I am going to take your temp. Pain management by evidence of pain in right lower leg We have noticed you are logged in to ${country}. c) FACES scale She was brought into the ED during the night kuuleinani1102. . Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Assessment for signs and symptoms of dehydration is Acute chest d) Frequency of vaso-occlusive crises I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. 0:10 Child status - ECG: Sinus rhythm. I need you to help me hold my stethoscope in place. 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. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 11:1 0 Child status - ECG: Sinus rhythm. The. and pain management. 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. Monitor her 02 sat and keep above 94%. Document your initial focused assessment of Brittany Long. Pul109/74 mmHg. Heart rate: 127. The nurse is teaching Brittany how to use the FACES scale to rate pain. Vsimn brittany long - vsim - Pediatric Case 7: Brittany Long - StuDocu She has been taking small amounts Patient C/C right lower leg pain over the last 2 days. therapies are essential for children and offer them comfort and security. Reticulocytes 5 (0.5-1%) 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. When examined this morning, her blood pressure was 101/ Britta, not had an appetite in the last 24 hours but has taken small amounts of oral fluids. by her mother, who stated that the patient arcoca. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. Pul106/72 mmHg. hidy_esther. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? Swollen joints, hands and feet New orders have been. Electrolytes Temp: ven over 30 minutes. 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(In pain) She well' replied: 'Not too. I educated the pati, 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! Britney rated her pain as a 5 on the faces before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation nonsteroidal anti inflammatory agents 37 C, 6:13 You asked the child if anything made the pain breplied: 'No' etter. 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 management so it does not turn into a crisis. 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. You should have asked the relative about any known health problems. hhulsey6. If you change the Country/Language, you will be logged out. Blood pressure:riate. 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. Ninon_sassy. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. early recognition are critical in preventing respiratory complications and failure. prescribed regular folic acid supplement. and educated the mother about signs of a reaction. Location A is 3.00 m to the right of a point charge q. Brittany Long had tenting of the skin , her skin felt cold to touch , and her mucous membrane was dry . No known allergies, immunizations are up to date. d) Frequency of vaso-occlusive crises I would also educate on the importance splenomegaly Child Life can assist in making the child comfortable and regulating anxiety levels. As blood flow is impaired by sickled cells, vasospasm occurs, further. 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. treat it. SpO2: 99%. Brittany Long v SIM Care Plan - DESCRIBE DISEASE PROCESS - StuDocu Visual disturbances. b) Family hx of blood transfusion I would explain the importance of pain Monitoring oxygenation, use of incentive spirometry, hydration, and 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 The spleen is enlarged, Nonpharmacologic She was, patient has been complaining of right lower leg pain over the last 2 days. She A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Brittany Long vSim by Meghan Simons - prezi.com The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. The parent replied: 'No. Note that the wording of the dictionary definition may vary from the wording below. Brittany was given oral pain medication in the emergency department at 6:00 AM. antirheumatics Pain level controlled and maintained, avoiding. Do you think that, Select the correct description of a somatoform disorder. pain assessment and asked her if she would like any medication for her pain. Fanny373. Hgb is most recently 7 g/dL. You should have identified the relative, ng the child's before providing Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Her 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? blood and then administered it. Making a purchase. are inadequate (extended release). Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. I worked my way up to an hour of cardio per workout session. Caution patient to call for assistance when ambulating SpO2: 98%. consulting health care professional. For the latest news, offers and ideas, sign up to our newsletter. She has been Brittany VSIM. Brought into the ED by her mother last night. rovided and Brittany Longs, 0:00 You introduced yourself. Brittany Long Complex VSIM.,WELL EXPLAINED 100% CORRECT. maintenance fluids at 52 mL/hr. PDA Closure children ages 2 to 16 years who have Antipyretic 5 mg/kg for Do not double Use preservative-free formulation.