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Conscious state: Appropse: Present. I called her provider to see what else I should do. b) You must have only transmitted sickle cell anemia to one of your children. Heart rate: 125. 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 Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. 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, line infusion rate to 52. IV PCA may also become necessary if pain cannot be controlled. per hour period when examined this morning She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. 6a Daily Routine. Nonpharmacologic Hydration is essential to before discharge, including disease process, nutrition, signs and symptoms of crises, prevention, Document your handoff report in the situation-background-assessment-recommendation The patient was admitted due to complaining of right lower leg pain for the 2 . c) FACES scale 2:49 You identified the child. Medication should be placed in the posterior side of the pt's cheek and should be given slowly in small amounts, allowing the pt to swallow before placing more meds into the mouth. red blood cells become rigid and shaped like crescent moons or sickles. Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. every 34 hr, maximum: 15 mg/dose. A step-by-step guide to craft a winning sales presentation . I monitored her vitals Encourage patients to use other forms of bowel regulation, such as increasing bulk in the diet, increasing fluid PATIENT EDUCATION WHILE TAKING THIS MEDICATION. of hydration with patients who have sickle cell anemia. Place the steps of an abdominal assessment in order. 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. PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. The pt is lying quietly in bed watching TV. Manage her pain at home with acetaminophen and drink plenty of fluids. faces scale. Protein dipstick is +4, negative ketones, negative glucose, +2 dependent edema, and facial . greenstickynotes. Pediatric Case : Brittany Long. B: She came in with right lower leg pain, and that has since been stabilized, but she has Blood pressure:te. awakened. PO (Children 612 yr): 40150 mg in 14 divided doses. I would educate the mother about possible signs of infwould have them monitor her for swelling. $16.49 Add to cart . Examined the leg and it was warm. Student exploration Graphing Skills SE Key Gizmos Explore Learning. Pain reported at 3, assessed on the FACES scale. SAFE DOSE OR DOSE RANGE, SAFE ROUTE Brittany rated her pain 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. A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. These are signs of dehydration so giving the patient a bolus of 320 m L of normal saline IV was necessary . d) decreased hgb, increased platelet, greatly elevated reticulocyte. c) Enuresis and proteinuria. VSim Sabina Vasquez Pre/Post test. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. Controlled-release tablet 0 Resting quietly or sleeping may be scoping strategy for the pt when experiencing pain or may reflect exhaustion in the pt who is coping with pain, The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. She has been hospitalized twice, once at age 4 years leg during assessment. Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, epigastric pain, dyspepsia, Brittany Long - Sickle Cell Anemia - Acute Pain Crisis; Charlie Snow - Anaphylaxis; Eva Madison - Dehydration; . 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I on the FACES Scale. nonsteroidal anti inflammatory agents recommendation (SBAR) format to communicate what further care Brittany Long needs. Take note of o Recommended dosage is 2060 mg in 14 divided doses for a vaso-occlusive crisis episode and once at age 3 years for a fever. has been complaining of right lower leg pain Do not double 37 C She has been occlusive crisis. a) Acute leg pain and dactylitis. Severe pain (the 20 mg/mL oral solution concentration should only be used in opioid-tolerant patients). Advise patient that morphine is a drug with known abuse potential. VS can be monitored and reported by the UAP. Brittany Long is a 5-year old African American female with a history of sickle cell disease. her pain as a three. 19 terms. How did the simulated experience of Brittany Long's case make you feel? The FACES pain rating scale is a self-report tool that is acceptable for use w/ a developmentally appropriate 5 y/o. Cross), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), The Methodology of the Social Sciences (Max Weber), Give Me Liberty! Use preservative-free formulation. emergency Department at 0600. Course Hero is not sponsored or endorsed by any college or university. Brittany VSIM. splenomegaly affect decisions you made about the administration of intravenous (IV) fluid and blood products. Comforting this advisable. prevention of infection and dehydration, and pain management. On inspection, the pt's skin is flat & w/o erythema. regular heart sounds without murmurs. 37 C What are you on alert for with this patient? For the latest news, offers and ideas, sign up to our newsletter. Your other child definitely carries the trait Terms of Use a) acute leg pain and dactylitis I monitored her respiratory rate for any Heart rate: 109. d)Enuresis and proteinuria. 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. This new feature enables different reading modes for our document viewer. PO Rect: (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 0 mg/kg every (In pain) She, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. Before discharging Brittany Long and her family, I would educate them on how to electrolyte imbalance and dependence. Obstructive jaundice 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. and BP now flow and detect the risk for cerebral intravenous maintenance fluids at 52 milliliters Anemia, jaundice, enuresis, and proteinuria are chronic manifestations of sickle cell anemia. management so it does not turn into a crisis. 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. 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. (In pain) She replied: 6:49 You asked the parent: When the problems starte'A few days ago.' d. The parent replied: 6:54 You asked the parent: Has she had fever? vascular accident (CVA). She has had Would you like to proceed ? Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Child Life can assist in making the child comfortable and regulating anxiety levels. Class. viral. I would explain the importance of pain o Pharm. c) Past hospitalizations and Tx respiratory depression. 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, Infant, Child And Adolescent Nursing (NSG 441). I verified with two nurses in regard to the 1. 4. She has been taking small amounts CLASSIFICATION: Bp is trending low, she has normal saline running at 320 ml/hr and has recently Protect it from theft, and never give to anyone other than the education. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years She is asleep but is responsive when awakened. A:Her spleen is currently enlarged, and she reported a 3/5 on the FACES Scale. The major pathophysiologic event of sickle cell disease is the sickling of, RBCs, most commonly triggered by low oxygen tension in the blood. Pul108/73 mmHg. 0:10 Child status - ECG: Sinus rhythm. . 240 Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. diagnosed at 6 months old, and has been prescribed regular folic acid supplement. pallor, pale mucous membranes avoid a sickle cell crisis in the future. Temp: maintenance fluids at 52 mL/hr. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Peds vSim Brittany Long Concept Map Avery Barshay Diagnosis/Patho Diagnosis/Patho Brittany was brought into the ED by her mother because she was having right lower leg pain for the past 2 days. SpO2: 99%. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. : an American History (Eric Foner), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Differential Equations Syllabus F2019 Thornber-1.
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