Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Start studying Vsim Olivia pre and post. ?? Confidentiality Guaranteed You can feel safe while using our website. Respiration: 35. c) Drinking to much water can trigger another crisis. Heart rate: 163. 2:57 You checked the pulse at the brachial artery. Blood pressure: 85/67 mmHg. Conscious state: Appropriate. ?? Temp: 37.5 C ?? On discharge Brittany and her mother should be taught on how to use the incentive spirometer, early recognition of signs and symptoms of a crisis, and pain management. This is correct. This website stores cookies on your computer. The temperature was 37.5 C. 3:36 You examined the child’s skin. This is correct. She is breathing at 35 breaths per minute. brittany vsim. Monitoring ms jones liver enzymes, chem panel, and coagulation studies will assist the nurse to determine if the pts A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal […] The nurse is reviewing lab data on a pt with sickle cell anemia. Respiration: 35. VS: Temp, 37.4 C oral; HR 120 bpm; RR 26 bpm; BP 100/60 mmHg; & SpO2 97%. It is important to use every opportunity to provide patient education. Breton cider is traditionally served in a bowl or a cup. However, if you don’t like your paper for some reason, you can always receive a refund. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. Brittany VSIM 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. Your name, position (RN), unit you are working on SITUATION Brittany Long is a 5-year-old African American female with a history of sickle cell anemia treated with regular folic acid supplement who came in yesterday with an acute vaso-occlusive pain crisis. Brittany VSIM 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. ?? [newline][newline]Once fluids and red blood cell transfusion are employed, red blood cells sequestered in the spleen are remobilized, the splenomegaly regresses, and the blood counts return to baseline. This will allow you to reassess the child continuously. 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 SpO2: 97%. Temp: 37.6 C ?? 2) What methods of pain management did you use and what other methods should be considered for Brittany, based on the latest evidence-based practice? These 7+ Pics Show Off Ricky Stenhouse’s Longtime Girlfriend, Brittany Long. It is important to use every opportunity to provide education. ?? Brittany also has a long beer-brewing tradition, tracing its roots back to the 17th century. I felt confident after completing my initial focused assessment of Brittany. Conscious state: Appropriate. Comforting the child with a favorite drink is advisable. Respiration: 35. Which lab findings would indicate the pt is experiencing a vast-occlusive crisis? Brittany VSIM 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. Consider providing education to relatives whenever possible. 11:19 You provided education to the relative regarding the child’s condition. 11:37 You asked the child if she had any pain. Heart rate: 164. Pulse: Present. Heart rate: 158. 8:43 You verified the blood, patient id, and type and cross match by two nurses. Respiration: 35. She continues to receive intravenous maintenance fluids at 52 mL/hr and is on a nasal cannula with oxygen 2 L/min. The nurse is assessing for which of the following complications of vast-occlusive crisis? ?? Conscious state: Appropriate. 3:19 You measured the temperature in the ear. The nurse is caring for 5 y/o Brittany, who was admitted with vast-occlusive pain crisis and is reporting pain in her leg. Heart rate: 168. Pulse: Present. Pulse: Present. 11:07 You provided patient education. 10:30 You assessed the child’s IV. Pulse: Present. The spleen is enlarged and the abdomen is generally tender. She is pale and weak and just wants to sleep. 13:10 Child status – ECG: Sinus tachycardia. 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? Blood pressure: 84/67 mmHg. She is breathing at 35 breaths per minute. Conscious state: Appropriate. brittany vsim Brittany VSIM 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. ?? ?? Learn vocabulary, terms, and more with flashcards, games, and other study tools. She replied: ‘Yes…’ She replied: ‘No, I don’t have any pain.’ ?? Blood pressure: 86/68 mmHg. The pulse is strong, 175 per minute and regular. 3:10 Child status – ECG: Sinus tachycardia. Conscious state: Appropriate. 13:31 A patient handoff was performed. Brittany VSIM 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. Conscious state: Appropriate. Which of the following would be the highest priority and most appropriate nursing diagnosis in this case? Blood pressure: 89/70 mmHg. Temp: 37.5 C ?? ???? a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. 6:09 You phoned the provider in order to discuss the patient. Our comprehensive range of products, services, and resources includes books supplied from more than … A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Temp: 37.5 C ?? Blood pressure: 88/70 mmHg. Pulse: Present. A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. Respiration: 35. VSIM For Nursing| Complex Pediatrics: Brittany Long - YouTube Conscious state: Appropriate. Young artisanal brewers are keeping a variety of beer types … 4) Reflect on ways to improve safety and quality of care based on your experience with Brittany’s case. This was reasonable. 5:08 You administered 2 mg of morphine IV. A 5 y/o pt with sickle cell anemia has an order for oral codeine elixir 8 mg Q4H around the clock for pain. 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. Which of the following would be the best response by the nurse? Find contact's direct phone number, email address, work history, and more. Which of the following responses by the nurse is correct? Only adults can become addicted to meds d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany… View Brittany Long's business profile at Life After Teaching. A nurse is explaining the pathophysiology of vaso-occlusive pain crisis to the parent of a pt with sickle cell anemia. To maintain patient safety it is important to wash your hands as soon as you enter the room. c) Morphine bc the pt reports severe pain. Pulse: Present. What action should the nurse take? Her urinary output is decreased, and she no longer wants to take fluids by mouth, not even for mom. Heart rate: 161. The parent replied: ‘No. 0:47 You identified the relatives. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal […] Which of the following should the nurse do? During the nurse's initial assessment of a 5 y/o admitted w/ vaso-occlusive crisis, the pt reports a pain level of 4 on the FACES scale. Respiration: 36. Temp: 37.5 C ?? It is correct to assess the child’s vital signs. This is very important to ensure patient safety. 3) How did the findings from Brittany’s physical assessment and diagnostic studies affect decisions you made about the administration of intravenous (IV) fluids and blood products? Heart rate: 159. 5:20 You provided patient education. The nurse is teaching Brittany how to use the FACES scale to rate pain. Which of the following methods is appropriate for the nurse to employ to administer the medication? Temp: 37.5 C 7:10 Child status – ECG: Sinus tachycardia. 2:48 You attached the pulse oximeter. Conscious state: Appropriate. Conscious state: Appropriate. TIME: 4 - 6 HOUR S STUDENT INSTRUCTIONS FOR VIRTUAL CLINICAL REPLACEMENT This activity packet is intended to be used with your assigned virtual patient found in vSim. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. 6:10 Child status – ECG: Sinus tachycardia. The nurse is caring for a pt weighing 16 kg with an order to administer acetaminophen (Tylenol) for acute pain crisis. 12:07 You gave the child a sip of juice. SpO2: 97%. The Six Step learn flow in vSim is to be followed as instructed below. Her spleen is palpated 3 cm below the left costal margin. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth. She rates her pain as a 5/5 on the FACES scale. Heart rate: 162. The dressing was dry and intact. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." A nurse is caring for a meds pt who was recently diagnosed with sickle cell anemia. 5:56 You attached the automatic noninvasive blood pressure (NIBP) measurement cuff. Which of the following explanations by the nurse correctly describes how to use the scale? Temp: 37.5 C ?? Pediatric Case 7: Brittany Long (Core) Pediatric Case 8: Brittany Long (Complex) Pediatric Case 9: Charlie Snow (Core) Pediatric Case 10: Charlie Snow (Complex) Textbook Conversion Guides. This was indicated by order. Her skin is quite cold. Brittany VSIM 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. Blood pressure: 96/75 mmHg. In more severe cases, in addition to fluid replacement, the administration of packed red blood cell transfusion is an emergent part of the treatment. Heart rate: 164. SpO2: 96%. All rights reserved. SpO2: 97%. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. Temp: 37.5 C ?? This is correct. What would be the most appropriate med for the nurse to administer? 11:10 Child status – ECG: Sinus tachycardia. Blood pressure: 88/70 mmHg. brittany vsim. Blood pressure: 98/76 mmHg. SpO2: 96%. The child answered 3 on the FACES pain scale with a range of 0 to 5. Which of the following should be included in the plan of care for this patient? 5:10 Child status – ECG: Sinus tachycardia. Respiration: 34. Her vital signs have been taken every 2 hours, and she had labs drawn twice. Her last hemoglobin was decreased by 1.3 g/dL, and is now 7.5 g/dL; platelets are also decreasing and are 200; her reticulocyte count is increasing and is 7.5. Conscious state: Appropriate. 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. Clinical signs of hypovolemia and shock (rapid pulse, decreased BP, decreased LOC and urine output) and of cardiovascular compromise must be monitored throughout. 1) What is the relationship between fluid and oxygen therapy in the treatment of sickle cell anemia? Temp: 37.5 C ?? 0:35 You identified the child. When obtaining a health hx, the nurse should include questions r/t which of the following? d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. 2:24 You looked for normal breathing. Temp: 37.6 C ?? After ending his 5-year-long relationship with fellow NASCAR driver, Danica Patrick, this rising champ has landed a new beauty in his life- and she is drop-dead gorgeous! The safe dosage range for children is 10 to 15 mg/kg/dose. vSim CLINICAL REPLACEMENT PACKET for STUDENTS EST. I felt like I knew what I was doing and what I should assess. You should reassess the child’s breathing at this point. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 0:07 You washed your hands. Legal consent to give blood products has been obtained from the mother. Advertisement. Assessing any IVs the child has is always important. The pt is lying quietly in bed watching TV. SpO2: 96%. I do not own this program, but this is really me taking care of Brittany Long. 4:18 You assessed the pain level using the FACES scale. Pulse: Present. [newline][newline]Because ASSC has approximately a 50% recurrence rate, parents should be taught to recognize the signs and symptoms, how to palpate the spleen, and the importance of seeking medical attention promptly. 10:45 You provided patient education. This is important, as the patient is below 18 years of age. Conscious state: Appropriate. Just invest tiny period to admission this on-line publication vsim for nursing maternity and pediatric as competently as evaluation them wherever you are now. Heart rate: 160. Pulse: Present. The site had no redness, swelling, infiltration, bleeding, or drainage. 8:10 Child status – ECG: Sinus tachycardia. Heart rate: 171. ?? 10:10 Child status – ECG: Sinus tachycardia. SpO2: 97%. ?? The scenarios are as follows: a) call the provider and request an order for a med for the itching as needed. If you are in doubt, it is always a good idea to repeat the identification. As one of the most popular academic writing platforms, Term Paper Geeks is known for its impeccable service and ever-growing customer base. Conscious state: Appropriate. This is reasonable. 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. Brittany has 7 jobs listed on their profile. It was reasonable to give an opioid here. 2:09 You asked the parent: Does she have any known allergies? Advertisement. (Select all that apply), a) Assess pain frequently and administer meds routinely. (In pain) She replied: ‘Yes please.’ ?? In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? 12:10 Child status – ECG: Sinus tachycardia. 1:04 You obtained legal consent from the child’s relative. The addiction will go away as soon as we stop giving her the morphine.