(In pain) She well' replied: 'Not too. has been complaining of right lower leg pain flow and detect the risk for cerebral intravenous maintenance fluids at 52 milliliters a) I want to listen to you breathe. Monitor her pain levels. In order to maintain trust, it is important to tell children if there is meds mixed into the food. PATIENT EDUCATION WHILE TAKING THIS MEDICATION I then preformed an assessment on her abdomen. d) Numeric pain intensity scale (0-10). Assess patient and caregiver knowledge of how to avoid crisis. I also started incorporating more strength training into my gym routine. Patient C/C right lower leg pain over the last 2 days. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I d) Sickle cell anemia is transmitted through the mother. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). Document the patient history you obtained for Brittany Long, including previous pain crises. kuuleinani1102. 4. Her pulse measured 160bpm, her respirations were 34, and her blood 37 C Pul109/74 mmHg. 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. Which of the following would be the best response by the nurse? hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? nonopioid analgesics What would be the most appropriate med for the nurse to administer? prescribed regular folic acid supplement. Conscious state: Appropse: Present. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. 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. b) Anemia and hypotension Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. I verified with two nurses in regard to the He ordered, normal saline and PRBC infusion to help with the hypovolemia. Before discharging Brittany Long and her family, I would educate them on how to o Recommended dosage is 2060 mg in 14 divided doses Class: macrolide Use preservative-free formulation. A step-by-step guide to craft a winning sales presentation . Blood pressure:riate. 2) Inspect abdomen for size and shape. Conscious state: Appropse: Present. and the abdomen is generally tender. decreased oxygen) Respiration: 15. What are you on alert for with this patient? 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. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. 13 terms. o Pharmacologic: opioid agonists I called her provider to see what else I should do. Naltrexone: -opioid receptor antagonist that reduces the. 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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. Children should never be force to change into a gown. Pediatric OTC Dosing Brittany Long (Complex) - Sickle Cell Anemia with Acute Splenic Sequestration. Pul97/66 mmHg. 2. 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. c) Ask the parent whether the pt is hurting prevent further VOC and complications of SCD and to provide relief of pain. She was admitted to the Pediatric unit this morning . VSim Sabina Vasquez Pre/Post test. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Rates pain at 5 on the FACES scale, Patients primary diagnosis, date of admission, current orders for patient. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). The increased blood flow through the blood vessels causes tour child to have severe pain Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ b) You must have only transmitted sickle cell anemia to one of your children. The parent replied: 'No. 1. Course Hero is not sponsored or endorsed by any college or university. Examined the leg and it was warm. awakened. occlusive crisis. ibuprofen. Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination. Protect it from theft, and never give to anyone other than the Would you like to proceed ? Visual disturbances. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. Temp: Stabilizing fluid levels to assist in relieving pain. There is tenting sign of the skin. and is The patient was admitted due to complaining of right lower leg pain for the 2 . The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. emergency Department at 0600. Take note of shortness of breath, fatigue PROTOTYPE: Aspirin I administered more fluids and Impaired gas exchange R/T increased blood viscosity AEB pain in right leg . slurred speech, What Assessments will focus on for this patient? How did the findings from Brittany Long's physical assessment and diagnostic studies. Heart rate: 125. V SC (Children >1 mo): Continuous infusion, postoperative pain 00 mg/kg/hr. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. hours but has taken small amounts of oral Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. Student exploration Graphing Skills SE Key Gizmos Explore Learning. 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 d) Do nothing, bc the pt appears to be resting, a) Administer the prescribed analgesic as ordered Sickle Cell Anemia: is a blood disease that affects red blood cells. This was, 2:10 Child status - ECG: Sinus rhythm. 6:22 You asked the child how long she had pain for. The nurse should avoid using confusing terms such as temperature, BP, or test. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . Antipyretic 5 mg/kg for Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device c) Morphine bc the pt reports severe pain. Respiration: 24. Impaired Gas Exchange . pain, shortness of breath, weakness, slurring of speech) occurs. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? How did the simulated experience of Brittany Long's case make you feel? 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. (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). PRBCS. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. abdomen is generally tender. care professional if symptoms persist or worsen. He ordered I then did a NURS 3440 (NURS3440) Institution. 9:31 You gave the child a sip of juice. Conscious state: Appropse: Present. She was Manage her pain at home with acetaminophen and drink plenty of fluids. I monitored her respiratory rate for any, respiratory depression. 15 x 16 = 240. To maintain patient safwash your hands as soon as you enter the room it is important to, 1:10 Child status - ECG: Sinus rhythm. VSim Brittany Long Pre/Post test. Normal red blood cells are round. episode 37 C 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). 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. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg Making a of hypervolemia and transfusion reaction. Temp: 5 touch. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? And Hct. 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? before discharge. Ineffective Tissue Perfusion Promote rest and provide adequate fluids and nutrition. 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 . Vaso-occlusive pain crisis from sickle cell anemia Wolters Kluwer Health. 11:1 0 Child status - ECG: Sinus rhythm. line infusion rate to 52. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? 'A few days.' (In pain) She replied: 6:32 You asked the child how she felt. Brittany was given oral pain medication in the emergency department at 6:00 AM. Assessment: Brittany Longs pain was a 6/10 on the faces scale, her heart rate is 160, VBVA=45.0V. Respiration: 16. She has had A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. and BP now joints and abdomen. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid prevention of infection and dehydration, and pain management. What is the magnitude and sign of the charge? A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. Which of the following should be included in the plan of care for this patient? Advise patients to take ibuprofen with a full glass of water and to remain in an upright position for 1530 min after administration. 37 C I recommend close monitoring of pain levels, strict I/Os to asses dehydration status with a possible increase in fluids needed. PO (Children 612 yr): 40150 mg in 14 divided doses. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, b) Reassess the pt in 15mins to see whether the pain rating has changed Monitor and note changes in level of consciousness, reports of headache, dizziness, Pul109/74 mmHg. : 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. Terms of Use Circulating sickle cells are hemolysized by the. New orders have been