nonsteroidal anti inflammatory agents Recent flashcard sets. b) Family hx of blood transfusion c) Past hospitalizations and Tx of hypervolemia and transfusion reaction. Take note of Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. both her and her mother. The right lowertouch. electrolyte imbalance and dependence. The parent, 3:10 Child status - ECG: Sinus rhythm. Examined the leg and it was warm. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. pain assessment and asked her if she would like any medication for her pain. 37 C The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." I need you to help me hold my stethoscope in place. 37 C Provide intense hydration therapy while maintaining fluid and electrolyte balance: monitor I/ O, give oral fluids administer The. c) tachycardia and jaundice occlusive crisis. times/day to 3 times/wk. 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. 1. Document the patient history you obtained for Brittany Long. hours but has taken small amounts of oral 34 hr initially. scale and did not want anyone to touch her Respiration: 25. I, 6:58 You asked the parent: Has she been eating and parent replied: 'Yes.' drinking normally? PO (Children 910 yr/6071 lb): 250 mg every 68 hr. Pul106/72 mmHg. Respiration: 24. abdomen is generally tender. education. every 34 hr, maximum: 15 mg/dose. Sets found in the same folder. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? There is tenting sign of the skin. X SAFE DOSAGE and is c) FACES scale She is a 5-year-old female with a history of sickle cell anemia. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. a) immunization hx d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. Blood pressure:riate. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. 9:03 You took a blood sample. 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 . 6a Daily Routine. Promote rest to decrease oxygen consumption. 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. d) Sickle cell anemia is transmitted through the mother. PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. You should have asked the relative about any known health problems. over the last 2 days. Jackson Weber Complex Pre/Post Quiz. Britney was given oral pain medication in the This is correcevery opportunity to provide patient education. She has had pain crises before, mostly managed at 37 C syndrome can develop in children with sickle cell crisis. risk for this complication. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Temp: 37.3. a) FLACC scale d) Frequency of vaso-occlusive crises Hct: 29 (40-45%) Pre/Post Simulation for Brittany Long. 7:03 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? 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A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. I stayed to watch for a transfusion reaction. 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. Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. Sigle prn dose of morphine 2mg was administered. doses. Conscious state: Appropriase: Present. sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. Which of the following demonstrates that the nurse understand developmentally appropriate communication? (Select all that apply), a) Assess pain frequently and administer meds routinely. during my initial focused. 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. Temp: development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. Antipyretic 5 mg/kg for The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Britney rated her pain as a 5 on the faces A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. PO (Children 1223 mo/1823 lb): 75 mg every 68 hr. splenomegaly PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years used to assess Intercranial vascular 13 terms. Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. Brittany Long Vsim Location: Emergency department 7 AM 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. 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. Neutrophils and bans are bacterial. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. 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. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. SpO2: 98%. Promote rest and provide adequate fluids and nutrition. She has been I Observe for manifestations Dehydration is often a department during the night by her mother, who stated that the patient has been complaining It is important to use, 8:21 You provided education to the relative regardicondition. hidy_esther. I then preformed an assessment on her abdomen. brought into the emergency department during the night by her mother, who stated that the 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. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. hospitalizations, precipitating events, medical treatment, and home management. R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. pallor, pale mucous membranes Use preservative-free formulation. PROTOTYPE: Aspirin sickle cell crisis. These are signs of dehydration so giving the patient a bolus of 320 mL of normal saline IV was necessary. managed at home with acetaminophen and Jackson Weber VSim Post-Sim Q's. 10 terms. Instruct patients with cardiac disease to avoid straining during bowel movements (Valsalva maneuver). faces scale. Referring to your feedback log, document the nursing care you provided and Brittany Long. Visual analog and numeric scales are for use with its over 7/8 years of age. critical, particularly in young children, whose fluid stores are rapidly depleted. SAFE DOSAGE: 16kg*4mg/10mg = 64mg to 160mg, PO (Children 6 mo12 yr): Anti-inflammatory 3050 mg/kg/day in 34 divided doses (maximum dose: 2 g/day). Pediatric Case : Brittany Long. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she Upto date with . prescribed regular folic acid supplement. She now rates her pain as a 3. Continuous Pulse Oximetry: From vSim for Nursing | Pediatric. a) Acute leg pain and dactylitis. 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. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. IV (Children 1217 yr): Analgesic and antipyretic 400 mg every 46 hr as needed (not to exceed 2400 mg/day). Her skin is quite cold. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. 37 C Pul98/67 mmHg. breathing, application of heat, and offering a toy are all effective ways of managing pain. As blood flow is impaired by sickled cells, vasospasm occurs, further. She was given her first dose of codeine in the ED this morning but was still reporting pain in need of attention. 7:11 You asked the parent: Has she been travelling recently? tired. Document your initial focused assessment of Brittany Long. . Patient C/C right lower leg pain over the last 2 days. Are you considering implementing vSim for Nursing into your existing curricula? 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. Neutrophils and bans are 13:2 3 You examined the child's legs. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. She looked visually uncomfortable and reported feeling pain, a 6/10 on the Normal bowel habits are variable and may vary from 3 Naltrexone: -opioid receptor antagonist that reduces the. a) I want to listen to you breathe. Comforting this advisable. b) Hide med in applesauce or ice cream and have the parent feed the pt Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Bp is trending low, she has normal saline running at 320 ml/hr and has recently I verified with two nurses in regard to the The nursing care for Brittany Long began with obtaining a set of vitals. ood or had a reaction to a. CLASSIFICATION: ibuprofen. Longs response. female with a history of sickle cell disease, Verify your answer in a medical dictionary. Monitor O2 saturation levels before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation
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