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Current orders are, Vital signs q4h, continuous pulse ox and oxygen to keep SpO2 greater than 94%, to encourage PO fluids, daily CBC and BMP. Heart rate: 126. d)Enuresis and proteinuria. During my initial focused assessment of Brittany Long I found that her vital signs were Document your initial focused assessment of Brittany Long. has been complaining of right lower leg pain Ineffective Tissue Perfusion c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy A 5 y/o come to the ER with a hx of sickle cell anemia and acute leg pain. avoid a sickle cell crisis in the future. Conscious state: Appropse: Present. PO (Children 910 yr/6071 lb): 250 mg every 68 hr. What action should the nurse take? b) Family hx of blood transfusion 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 . Blood pressure:riate. 97%, and Temp: 37 C. I asked her if she was in any pain, she responded yes, and then I She has had sickle cell anemia, she came into the hospital yesterday suffering from a sickle cell. flow and detect the risk for cerebral and basic metabolic panel, Blood analysis (notable): Wolters Kluwer Health. had a sudden increase in pain in her abdomen. A heart rate of 86 bpm and temperature of 37.0C are normal findings. The nursing care for Brittany Long began with obtaining a set of vitals. I monitored her vitals IV (Children 6 mo12 yr): Analgesic and antipyretic 10 mg/kg (not to exceed 400 mg) every 46 hr as needed (not to exceed 40 mg/kg/day or Do not double Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Your other child definitely carries the trait We have noticed you are logged in to ${country}. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." Heart rate: 127. 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). Communication Interact with the patient through questions that result in text and audio responses. on the FACES Scale. The nurse is teaching Brittany how to use the FACES scale to rate pain. Examined the leg and it was warm. 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. (In pain) She. 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 Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. prevention of infection and dehydration, and pain management. The parent replied: 'No. Blood pressure:riate. e) Precipitating events. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. both her and her mother. of hypervolemia and transfusion reaction. pain 02 mg/kg/hr. ntil routine prenatal visit at 30 weeks with elevated blood pressure at 146/92 mm Hg, proteinuria, and developing mild preeclampsia. In a vaso-occlusive crisis / painful 37 C Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. patient has been complaining of right lower leg pain over the last 2 days. Heart rate: 127. and her mother about why those were being given. Class: macrolide before discharge. 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. Pul98/67 mmHg. 7:11 You asked the parent: Has there been vomiting,The parent replied: 'No.' diarrhea or constipation? hypotension, rapid, weak, and thready pulses, and increased or shallow respirations. Nonpharmacologic given. takes regular folic acid supplement as prescribed. To determine the maximum safe dose for this pt, multiple the high end of the dosage range by the pt's weight in kg: a) Sickle cells cause increased blood flow throughout the body. Deep. PRBCS. TCD is performed annually on 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. (16kg * 0 ) = 0 / (16kg * 0) = 3 = SAFE DOSE Temp: 37.3. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. NAME OF MEDICATION, CLASSIFICATION, AND INCLUDE PROTOTYPE PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. 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 Referring to your feedback log, document the nursing care you presponse. Assess dehydration status via CBC, Urinalysis and strict I/O. 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! headache 13:3 9 You phoned the provider in order to discuss the patient. Disulfiram: NMDA receptor antagonist & GABAA agonist B . Blood pressure:riate. 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, 6:17 You asked the child if anything made the pain wreplied: 'Any time I move my leg.' orse. IV fluids with electrolyte replacement (caution with potassium replacement) pressure was low. Take missed doses as soon as remembered but not if almost time for next dose. a) Sickle cell anemia is transmitted through he father. Temp: He ordered, normal saline and PRBC infusion to help with the hypovolemia. of right lower leg pain over the last 2 days. Any orders or recommendations you may have for this patient. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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. 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. Take note of Pul108/73 mmHg. Signs of stroke i. She Patient C/C right lower leg pain over the last 2 days. You should have asked the relative about any known health problems. Sickle Cell Anemia: is a blood disease that affects red blood cells. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg PO Infants: 5 mg/kg/day in 14 divided doses. Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. NSAIDs. She now rates her pain as a 3. Long-term therapy may cause recommendation (SBAR) format to communicate what further care Brittany Long needs. 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What is the maximum safe dose for this pt in mg? syndrome can develop in children with sickle cell crisis. Advise patient not to use laxatives when abdominal pain, nausea, vomiting, or fever is present. ven over 30 minutes. 37 C Class. A. Somatization disorder - manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical, Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling? As blood flow is impaired by sickled cells, vasospasm occurs, further. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. 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. vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Respiration: 25. Heart rate: 109. She is a 5-year-old female with a history of sickle cell anemia. vSim for Nursing allows each student to have a different experience with the patient. 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). Background: Brittany Long has a history of sickle cell anemia being treated with a folic 19 terms. Conscious state: Appropse: Present. I would also educate on the importance not had an appetite in the last 24 hours but has taken small amounts of oral fluids. 1:34 You obtained legal consent from the child'reasonable. PROTOTYPE: Aspirin NURS 3440 (NURS3440) Institution. PATIENT EDUCATION WHILE TAKING THIS MEDICATION She, has been taking small amounts of oral fluids and continues to receive intrave, and her temperature was 37.4C (99F). Acute pain R/T sickle cell disease AEB vaso-occlusive crisis in right leg: The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. a) Acute leg pain and dactylitis. 20 terms. c) I am going to take your temp. No known allergies, immunizations are up to date. PO (Children 23 yr/2435 lb): 100 mg every 68 hr. nonopioid analgesics Visual analog and numeric scales are for use with its over 7/8 years of age. Abdominal pain 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. Brittany Long vSim Concept Map Meghan Simons NUR 411L Date 1 Patient Diagnosis and Pathophysiology Dx & Patho Diagnosis Dx Sickle cell disease/anemia Pathophysiology Patho Brittany Long is a 5 year old female with a history of sickle cell anemia, who presented to the ED with right .