Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Administer oxygen as prescribed if hypoxia is present. I listened to her lungs (clear and equal bilaterally), checked h(99%), checked her pulse, attached the NIBP (110/74), took heer RR (24), attached the pulse ox r temp (37), did a pain Blood pressure:riate. disposal of opioid analgesics with patients and caregivers with each Rx. 19 terms. provided education to Acute Pain The Conscious state: Appropriase: Present. X SAFE DOSAGE Keep Identify and document key nursing diagnoses for Brittany Long. Manage her pain at home with acetaminophen and drink plenty of fluids. 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. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. 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. 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. The right lowertouch. Bp is trending low, she has normal saline running at 320 ml/hr and has recently PO Infants: 5 mg/kg/day in 14 divided doses. Severe headache, vomiting, visual changes, Use preservative-free formulation. If that is not sufficient to manage their pain, they may require morphine for Pul109/74 mmHg. individual for whom it was prescribed. 1 CHE101 - Summary Chemistry: The Central Science, Ethan Haas - Podcasts and Oral Histories Homework, C225 Task 2- Literature Review - Education Research - Decoding Words And Multi-Syllables, PSY HW#3 - Homework on habituation, secure and insecure attachment and the stage theory, Lesson 17 Types of Lava and the Features They Form, 1010 - Summary Worlds Together Worlds Apart, Lessons from Antiquity Activities US Government, Kami Export - Jacob Wilson - Copy of Independent and Dependent Variables Scenarios - Google Docs, SCS 200 Applied Social Sciences Module 1 Short Answers, Greek god program by alex eubank pdf free, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Lab 3 Measurement Measuring Volume SE (Auto Recovered), Ati-rn-comprehensive-predictor-retake-2019-100-correct-ati-rn-comprehensive-predictor-retake-1 ATI RN COMPREHENSIVE PREDICTOR RETAKE 2019_100% Correct | ATI RN COMPREHENSIVE PREDICTOR RETAKE, 1-2 Module One Activity Project topic exploration, Laporan Praktikum Kimia Dasar II Reaksi Redoks KEL5, 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, Nursing Care of the Childbearing Family (NURS 125), Closely observe for manifestations of crisis and infection. Morphine 2mg IV given as TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. b) Family hx of blood transfusion During my initial focused assessment of Brittany Long I found that her vital signs were She has been taking small amounts This was, 2:10 Child status - ECG: Sinus rhythm. Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Pediatric Case 7: Brittany Long (Core) 1. vSIM Brittany Long .pdf - STUDENT CLINICAL REPLACEMENT. a) immunization hx Pul110/74 mmHg. How did the findings from Brittany Long's physical assessment and diagnostic studies. Course Hero is not sponsored or endorsed by any college or university. Brought into the ED by her mother last night. of hydration with patients who have sickle cell anemia. managed at home with acetaminophen and Encourage patients who are immobilized or on prolonged bedrest to turn, cough, and breathe deeply every 2 hr to prevent Document the patient history you obtained for Brittany Long, including previous pain crises. Pul110/74 mmHg. IV (Neonates Gestational age 32 wk, 5001500 g): 10 mg/kg followed by two doses of 5 mg/kg at 24 and 48 hr after initial dose. Temp: development of sensory and motor deficits (hemiparesis or paralysis), and seizure activity. Pul108/73 mmHg. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device dispensed with the medication. 4. of hypervolemia and transfusion reaction. Temp: The increased blood flow through the blood vessels causes tour child to have severe pain When assessing a preschool-aged pt, the pt can sit in the caregiver;s lap or sit on the exam table w/i reach and eye contact of the caregiver. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: PO (Children 68 yr/4859 lb): 200 mg every 68 hr. Brittany Long is a 5-year-old African American female with a history of sickle cell disease, You should have identified the relative, ng the child's before providing allergies and then I gave her 2 mg IV push Morphine sulfate to treat her pain. This is reasonable. c) I am going to take your temp. She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. She has pain a 6/10 on the faces scale and is receiving morphine to 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? She is on D5NS fluids at 52 mL/hr. every 34 hr, maximum: 15 mg/dose. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness 37 C Heart rate: 127. viral. a) I want to listen to you breathe. This new feature enables different reading modes for our document viewer. Advise patient that morphine is a drug with known abuse potential. 0:25 You washed your hands. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. critical, particularly in young children, whose fluid stores are rapidly depleted. Advise patient to inform health care professional of medication regimen prior to treatment or surgery. Her Disulfiram: NMDA receptor antagonist & GABAA agonist B . Respiration: 24. Recommendation: Educate the patient and family about the importance of hydration A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. 26% She signs Q2 hours. also on 2L nasal cannula. A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. and the abdomen is generally tender. hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). 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. Company Registration Number: 61965243 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. hidy_esther. I worked my way up to an hour of cardio per workout session. 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 . Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. 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. The patient was diagnosed with sickle cell anemia and was in a IF you have four children, one or 25% will have sickle cell anemia. Blood pressure:riate. unstable. I would also educate on the importance 2:49 You identified the child. She rates her pain as a 5/5 on the FACES scale. The potential difference between the two locations is. VBVA=45.0V.V _ { B } - V _ { A } = 45.0 \mathrm { V }. for a vaso-occlusive crisis episode and once at age 3 years for a fever. Hgb 9 (13.5-17) sickle cell disease. 1:34 You obtained legal consent from the child'reasonable. vSim - Brittany Long. In people with sickle cell 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! episode and once at age 3 years for a fever. Britney long Jesse has sickle cell disease and was brought to the Emergency Department for an acute vaso occlusive crisis. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Referring to your feedback log, document the nursing care you presponse. The faulty hemoglobin is called hemoglobin S (HgbS), and it replaces normal hemoglobin which is called hemoglobin A (HgbA). Hypertension and tachycardia are often associated with acute pain. anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. 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. electrolyte imbalance and dependence. Which of the following explanations b the nurse is correct? Britney was given oral pain medication in the 8:10 Child status - ECG: Sinus rhythm. determine anemia state & if there is Hematuria Britney long is a 5 year old African American Identify and document key nursing diagnoses for Brittany Long: Brittany Long needs the following diagnosis:. headache The nurse is reviewing lab data on a pt with sickle cell anemia. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. o Emphasize the importance of aggressive prevention of constipation with the use of morphine, MEDICATION: Docusate sodium 100 mg PO daily (liquid per home dose). A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. education. Sets found in the same folder. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. And Hct. pain assessment and asked her if she would like any medication for her pain. 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. greenstickynotes. home with acetaminophen and ibuprofen. nonsteroidal anti inflammatory agents Severe pain, usually in bones She was rovided and Brittany Longs, 0:00 You introduced yourself. Ineffective Tissue Perfusion o Pharmacologic: opioid agonists Pain reported at 3, assessed on the FACES scale. Blood pressure:riate. Pediatric Case : Brittany Long. Advise patient not to take docusate within 2 hr of other laxatives. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I Advise patient to change positions slowly to minimize orthostatic hypotension. School Herzing University; Course Title PN 124; Uploaded By hana254830. o Ther. 19 terms. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. a) Sickle cell anemia is transmitted through he father. Comforting this advisable. IV Neonates: Continuous infusion 00 mg/kg/hr. Naltrexone: -opioid receptor antagonist that reduces the. prevent further VOC and complications of SCD and to provide relief of pain. Making a purchase. Brittany Any orders or recommendations you may have for this patient. Conscious state: Appropse: Present. 240 has been taking small amounts of oral fluids and continues to receive intravenous Which of the following explanations by the nurse correctly describes how to use the scale? A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 1) Have the patient lie down in a supine position. 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. Which of the following responses by the nurse is correct? 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. North Carolina State University. Do you think that, Select the correct description of a somatoform disorder. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. What are you on alert for with this patient? (In pain) She well' replied: 'Not too. It is not necessary to give combining terms for words in parentheses. Long-term therapy may cause Controlled-release tablet 0 Monitor O2 saturation levels Hct: 29 (40-45%) SpO2: 97%. Student exploration Graphing Skills SE Key Gizmos Explore Learning. hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Leadership and Management in Nursing (NUR 4773), Advanced Concepts in Applied Behavior Analysis (PSY7709), Intermediate Medical Surgical Nursing (NRSG 250), 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), Ch. 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. I f dehydration, look at her legs frequently. d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. shortness of breath, fatigue dizziness both her and her mother. ven over 30 minutes. SpO2: 99%. d) Sickle cell anemia is transmitted through the mother. red blood cells become rigid and shaped like crescent moons or sickles. She also did n't have any energy to eat anything by mouth . encouraged PO fluids and she drank some. The spleen is enlarged, 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 b) Tachycardia and jaundice. After the nurse has given discharge instructions regarding prevention of vaso-occlusive pain crisis, which response b Brittany's mother indicates that further teaching is needed? 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. 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Impaired Gas Exchange She now rates her pain as a 3. o Therapeutic: opioid analgesics a) immunization hx a) Sickle cells cause increased blood flow throughout the body. once at age 4 years for vaso-occlusive crisis Do not double Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Strict I and Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Brittany VSIM. jaundice dispensed with the medication. Conscious state: Appropriate. 13:2 3 You examined the child's legs. I need you to help me hold my stethoscope in place. lymphocytes monocytes increase is Tolerance is not addiction. A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. brought into the emergency department during the night by her mother, who stated that the Sickled RBCs, become rigid and cresent shaped. SpO2: 99%. Temp: I monitored her respiratory rate for any, respiratory depression. The parent, 3:10 Child status - ECG: Sinus rhythm. She has Over time, the red blood cells become rigid and shaped like crescent moons or sickles. She ha, pain crises before, mostly managed at home with acetaminophen and ibuprofen. 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! We have noticed you are logged in to ${country}. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication.
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