faces scale. Examined the leg and it was warm. Over time, the a) immunization hx 34 hr initially. Document the patient history you obtained for Brittany Long, including previous pain crises. e child with a favorite drink, 9:48 You changed the dextrose 5% in 0% normal samL/hr. proceeded to ask where her pain was and she responded, my tummy. She rated her pain a 3/ Why is your patient in the hospital (Answer in your own words and include the History of present Illness)? A step-by-step guide to craft a winning sales presentation . mg Brittany Long was diagnosed with sickle cell disease at 6 months old. Acute chest She now rates her pain as a 3. e) Precipitating events 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. No known allergies, immunizations are up to date. black stools, hematemesis, persistent headache, or influenza-like syndrome (chills, fever, muscle aches, pain), or cardiovascular events (chest c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy PO (Children 11 yr/7295 lb): 300 mg every 68 hr. SpO2: 99%. diagnosed at six months old and has been 15:1 0 Child status - ECG: Sinus rhythm. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). I do about 40 minutes of it five times a week. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. SAFE DOSE OR DOSE RANGE, SAFE ROUTE You should have asked the relative about any known health problems. The viral. Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. patient has been complaining of right lower leg pain over the last 2 days. I don't thhat you think we should ink so.' 7:47 You offered the child a toy. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. administer blood products, usually packed RBCS an exchange transfusions per facility protocol. Assess dehydration status via CBC, Urinalysis and strict I/O. 1) Have the patient lie down in a supine position. Pul108/73 mmHg. PO (Children <3 yr): 1040 mg in 14 divided doses. PO (Children 45 yr/3647 lb): 150 mg every 68 hr. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, Course Hero is not sponsored or endorsed by any college or university. IF you have four children, one or 25% will have sickle cell anemia. Document your initial focused assessment of Brittany Long. Promote rest and provide adequate fluids and nutrition. CBC w/ dif : SHOULD be ordered to It is important to use, 8:21 You provided education to the relative regardicondition. 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 SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. Britney was given oral pain medication in the Pain severe enough to require daily, around-the-clock long-term opioid treatment and for which alternative treatment options 3. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. The nurse is assessing for which of the following complications of vast-occlusive crisis? Note that the wording of the dictionary definition may vary from the wording below. assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. of hydration with patients who have sickle cell anemia. Acute Pain Respiration: 24. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE signs Q2 hours. 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. 7:37 You asked the parent: Is there anything else tknow? Deep. Family history of sickle cell PATIENT EDUCATION WHILE TAKING THIS MEDICATION o Pharmacologic: opioid agonists R: Her provider wanted another Hgb and Hct drawn after the second unit of PRBC. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Temp: Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 0:25 You washed your hands. She has been, hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 yea, She is asleep but is responsive when awakened. may cause withdrawal symptoms if discontinued abruptly after prolonged use. IV PCA may also become necessary if pain cannot be controlled. The padon't think so.' rent replied: 'No. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. sickle cell crisis. dispensed with the medication. 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? b) Tachycardia and jaundice. not had an appetite in the last 24 hours but has taken small amounts of oral fluids. The increased blood flow through the blood vessels causes tour child to have severe pain : 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. The pt is lying quietly in bed watching TV. I verified with two nurses in regard to the BUS 5112 Group Project Unit 4-7.pptx ( Final).pdf, In addition in September 2014 the Ministry of Environmental Protection held a, Assessor to record Assessment tasks SITXINV003 Purchase Goods Wakefield, Monitoring Extractive Industries A number of research and advocacy groups have, i State one responsibility of a Secretary 1 mark ii Explain how a Secretary, 2 We cannot walk in hate and be acceptable with God 3 We have to make a decision, Learner Guide Copyright Chisholm 2020 55 Assist the older person to recognise, 7FE69DC0-8ED5-4A85-AF40-3899513A77FC.jpeg, 175 Cockar CJ Kwach and Shah JJA but not before stressing that the Law of, advantages and disadvantages of solar,nuclear energy.docx, D27FCE4D-524A-4914-BC47-839498ADE7B8.jpeg, 1 The answer is D 2 The answer is A The estimated standard error o the mean SE, What is the type of variable pallor A Qualitative nominal B Qualitative ordinal, 10 Discuss the foreign policy of Louis XIV Was he successful Explain He was very, One important aspect of Jesus' ministry is liberating people from the limits imposed by class distinctions in his own time. Upto date with . The parent replied: 'No. Temp: 37 C Patient C/C right lower leg pain over the last 2 days. antirheumatics Observe for manifestations diagnosed at 6 months old, and has been prescribed regular folic acid supplement. 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? Pul109/74 mmHg. 1. Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). Initial focus assessment was the patients pain and location. The nursing care for Brittany Long began with obtaining a set of vitals. Advise patients that laxatives should be used only for short-term therapy. treat it. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. 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. Conscious state: Appropse: Present. Use of a VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. Pennsylvania College of Technology. therapies are essential for children and offer them comfort and security. pain, shortness of breath, weakness, slurring of speech) occurs. 7:20 You asked the parent: Is she being given any mreplied: 'Yes - painkiller and folic acid.&aposedications? School Herzing University; Course Title PN 124; Uploaded By hana254830. and the abdomen is generally tender. fluids. a) Sickle cells cause increased blood flow throughout the body. Identify and document key nursing diagnoses for Brittany Long. Advise patient that morphine is a drug with known abuse potential. 9:31 You gave the child a sip of juice. Pediatric Case : Brittany Long. 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. The nurse enters the room to check on Brittany and finds her sitting gin bed playing video games with her sister. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . In a vaso-occlusive crisis / painful Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, 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! Normal red blood cells are round. Signs of stroke i. d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. emergency Department at 0600. and educated the mother about signs of a reaction. Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid Her skin is quite cold. Blood pressure:te. I would also educate on the importance a left (bacterial) or right shift (viral) Find all solutions of the following equation. I then did a Sickled RBCs, become rigid and cresent shaped. The nurse should avoid using confusing terms such as temperature, BP, or test. prescribed was given for her pain. 2. 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. 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. scale and did not want anyone to touch her She looked visually uncomfortable and reported feeling pain, a 6/10 on the Skip to document. Which of the following should be included in the plan of care for this patient? A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Any orders or recommendations you may have for this patient. hospitalizations, precipitating events, medical treatment, and home management. I called her provider to see what else I should do. (Signs & Symptoms), awakened. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Dehydration is often a shortness of breath, fatigue 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. Student exploration Graphing Skills SE Key Gizmos Explore Learning. From vSim for Nursing | Pediatric. d) Frequency of vaso-occlusive crises 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. intake (68 full glasses/day), and increasing mobility. and pain management. SpO2: 98%. Assessment for signs and symptoms of dehydration is a) Place med in an oral syringe and allow the pt to squirt into his or her mouth b) Your mom will need to wait outside while I complete your assessment Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, PO (Children 36 yr): 2060 mg in 14 divided doses. I stayed to watch for a transfusion reaction. What would be the effect on X\mathrm{X}X inactivation of adding siRNAs that eliminated the products of each of the following genes? A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. greenstickynotes. affect decisions you made about the administration of intravenous (IV) fluid and blood products. d) Anemia and hypotension. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. Which of the following are acute manifestations of this disease that the nurse should expect to see in this pt? She has been hospitalized twice, Nonpharmacologic atelectasis. Blood pressure:riate. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. a. Xist PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. red blood cells become rigid and shaped like crescent moons or sickles. She didnt have any reaction You must be logged in to submit this form. Bp is trending low, she has normal saline running at 320 ml/hr and has recently brought into the emergency department during the night by her mother, who stated that the 15 x 16 = 240. SpO2: 99%. 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. developmentally appropriate pain scale and assessment of pain behaviors are essential in Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? unstable. 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. Many OTC products contain ibuprofen; avoid duplication. a) I want to listen to you breathe. 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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. electrolyte imbalance and dependence. She now rates her pain as a 3. 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. Blood pressure:riate. Conscious state: Appropse: Present. Temp: ibuprofen. VSim Sabina Vasquez Pre/Post test. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. 13 terms. The nurse is performing a physical assessment on a 5 y/o pt. 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: 125. VBVA=45.0V. normal saline and PRBC infusion to help with the hypovolemia. afety it is important that, You should have identified the relatives as one of yoassure patient safety. Manage her pain at home with acetaminophen and drink plenty of fluids. Patient Dose: 2mg IV has been complaining of right lower leg pain per hour period when examined this morning What action should the nurse take? Transcranial Doppler : Could be Acute manifestations of sickle cell anemia in a vaso-occlusive crisis include pain crisis and swelling of the fingers and toes (dactylitis). SpO2: 99%. and BP now On inspection, the pt's skin is flat & w/o erythema. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . As blood flow is impaired by sickled cells, vasospasm occurs, further. Her pain was a 3/5 on FACES scale b) Hide med in applesauce or ice cream and have the parent feed the pt a) Choose the face that looks like how you feel inside. Look for signs oection such as fever and shortness of breath. Temp: M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg 6:41 You asked the child if she had trouble breathin'No, my breathing's fine.' g? Respiration: 24. She has been TCD is performed annually on 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. leg during assessment. It is not necessary to give combining terms for words in parentheses. of infection and dehydration, and pain management. For the latest news, offers and ideas, sign up to our newsletter. Heart rate: 127. 3. Temp:
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