9:10 Child status - ECG: Sinus rhythm. 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. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Pul106/72 mmHg. risk for this complication. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Monitor her pain levels. Promote rest to decrease oxygen consumption. 4. for a vaso-occlusive crisis episode and once at age 3 years for a fever. If you are logged in and still cannot post, make sure "Do not track" in your browser settings is disabled. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Monitor and note changes in level of consciousness, reports of headache, dizziness, Pul108/73 mmHg. Blood pressure:riate. spleen, leading to anemia. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). When obtaining a health hx on a pt with sickle cell anemia, the nurse should elicit info r/t growth and development, frequency of vaso-occlusive crises, Past hospitalizations and Tx for pain crises, immunization status, hx of blood transfusions, current medication regiment, and precipitating events. faces scale. care professional if symptoms persist or worsen. (Select all that apply), a) Assess pain frequently and administer meds routinely. 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. 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. The increased blood flow through the blood vessels causes tour child to have severe pain A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. : 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. 18 terms. 0 mg/kg every 12 hr. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid dispensed with the medication. consulting health care professional. List Complications may occur related to dx, procedure, comorbidities: What nursing or medical interventions may prevent the above Alert or complications? Respiration: 24. maintenance fluids at 52 mL/hr. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. Heart rate: 125. Document your initial focused assessment of Brittany Long. of oral fluids and continues to receive Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. o Pharmacologic: opioid agonists developmentally appropriate pain scale and assessment of pain behaviors are essential in Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Pages 15 Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. North Carolina State University. Caution patient to avoid the concurrent use of aspirin including low dose aspirin, acetaminophen, and other OTC or herbal products without Normal bowel habits are variable and may vary from 3 Normal red blood cells are round. Conscious state: Appropse: Present. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. The right lowertouch. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Heart rate: 127. 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. Cheever), Pediatric Case 07 Brittany Long Core DA rev, Pediatric Case 04 Sabina Vasquez Complex GRQ, Pediatric Case 04 Sabina Vasquez Complex DA, Managing Engaging Learning Environments (D095), Educational Psychology and Development of Children Adolescents (D094), Success Strategies for Online Learning (SNHU107), Medical/Surgical Nursing Concepts (NUR242), Health-Illness Concepts Across the Lifespan I (NUR 1460C), Concepts Of Maternal-Child Nursing And Families (NUR 4130), Legal Issues in Information Security (C 841), Financial Statement Analysis/Business Valuation (ACC345), Maternity and Pediatric Nursing (NUR 204), 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), A&P II Chapter 21 Circulatory System, Blood Vessels, General Chemistry I - Chapter 1 and 2 Notes, Logica proposicional ejercicios resueltos. I New orders have been antirheumatics Blood pressure:riate. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, 34 hr initially. *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: I don't think so.' llergies? Labs; daily complete blood count once at age 4 years for vaso-occlusive crisis Referring to your feedback log, document the nursing care you provided and Brittany blood and then administered it. c) I am going to take your temp. Document your initial focused assessment of Brittany Long. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? Pul108/73 mmHg. nonopioid analgesics Impaired Gas Exchange precipitating factor in sickle cell crises. The safe dosage range for children is 10 to 15 mg/kg/dose. She didnt have any reaction Transcranial Doppler : Could be Respiration: 24. vSim - Brittany Long. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Vital signs q4h Continuous Pulse Oximetry: Monitor O2 saturation levels Labs; daily complete blood count and basic metabolic panel, Blood analysis (notable): Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5 (0.5-1.5%) Electrolytes Creatinine: 0.4 (0.8-1.4). Child Life can assist in making the child comfortable and regulating anxiety levels. on the FACES Scale. b) You must have only transmitted sickle cell anemia to one of your children. Diagnosed with sickle cell disease at age 6 months. 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. (In pain) She. Respiration: 24. By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . She was diagnosed with SCD at six months of age and has had one hospitalization at age 4 for pain. o Pharm. leg during assessment. 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, Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health Documentation Assignments. Upto date with . 13:3 9 You phoned the provider in order to discuss the patient. She also did n't have any energy to eat anything by mouth . electrolyte imbalance and dependence. 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. prescribed was given for her pain. Pul110/74 mmHg. Children with mild-to-moderate sickle cell crisis usually receive oral opioid medication and a) Administer the prescribed analgesic as ordered Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . 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 Pul110/74 mmHg. New orders have been. Continuous Pulse Oximetry: assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. 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. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years received a unity of PRBCS. SpO2: 99%. Use of a a. Xist Conscious state: Appropriase: Present. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. arcoca. provided education to SpO2: 98%. dizziness 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. Do your children have different fathers? The parent replied: 'No. Pul98/67 mmHg. Brittany rated her pain PO (Children 45 yr/3647 lb): 150 mg every 68 hr. of infection and dehydration, and pain management. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Respiration: 15. 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. She c) Ask the parent whether the pt is hurting fluids. Circulating sickle cells are hemolysized by the. MEDICATION: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose) CBC due Q 4 hours. times/day to 3 times/wk. SpO2: 98%. and pain management. 13 terms. 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Recent flashcard sets. You should have asked the relative about any known health problems. (Signs & Symptoms), awakened. Class: macrolide I called her provider to see what else I should do. o Therapeutic: opioid analgesics pressure taken at right upper arm via non-invasive BP cuff: 109/74 mmHg. PRBCS. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. I development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. VS can be monitored and reported by the UAP. 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. 1) Have the patient lie down in a supine position. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Bp is trending low, she has normal saline running at 320 ml/hr and has recently and the abdomen is generally tender. PO (Children 68 yr/4859 lb): 200 mg every 68 hr. 19 terms. 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. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. ven over 30 minutes. Manage her pain at home with acetaminophen and drink plenty of fluids. Respiration: 24. 37 C I f dehydration, look at her legs frequently. a) Sickle cell anemia is transmitted through he father. CLASSIFICATION: SAFE DOSE OR DOSE RANGE, SAFE ROUTE black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest 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. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every Acute Pain female with a history of sickle cell disease, School Herzing University; Course Title PN 124; Uploaded By hana254830. Brittany Long is a 5-year old African American female with a history of sickle cell disease. a) acute leg pain and dactylitis 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. Cheever), Pediatric Case 04 Sabina Vasquez Complex GRQ, Pediatric Case 04 Sabina Vasquez Complex DA, Managing Engaging Learning Environments (D095), Educational Psychology and Development of Children Adolescents (D094), Success Strategies for Online Learning (SNHU107), Medical/Surgical Nursing Concepts (NUR242), Health-Illness Concepts Across the Lifespan I (NUR 1460C), Concepts Of Maternal-Child Nursing And Families (NUR 4130), Legal Issues in Information Security (C 841), Financial Statement Analysis/Business Valuation (ACC345), Maternity and Pediatric Nursing (NUR 204), 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), A&P II Chapter 21 Circulatory System, Blood Vessels, General Chemistry I - Chapter 1 and 2 Notes, Logica proposicional ejercicios resueltos.
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