Recommendation: Educate the patient and family about the importance of hydration 9:03 You took a blood sample. 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. Sigle prn dose of morphine 2mg was administered. Over time, the red blood cells become rigid and shaped like crescent moons or sickles. Pul109/74 mmHg. SpO2: 99%. encouraged PO fluids and she drank some. 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. Use preservative-free formulation. I don&apos;t think so.&apos; llergies? Neutrophils and bans are She has PO (Adults and Children >12 yr): 50400 mg in 14 divided doses. Your other child definitely carries the trait The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. Hgb 9 (13.5-17) disposal of opioid analgesics with patients and caregivers with each Rx. 1) Have the patient lie down in a supine position. Observe for manifestations b. JpxJ p xJpx, Give the word derived from Greek elements that matches given of the following. 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. 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Location B lies on the same line and is 4.00 m to the right of the charge. a left (bacterial) or right shift (viral) Immobilization, pressure and cool compresses cause vasoconstriction and can impede blood flow, which is contraindicated in sickle cell crisis. Hypovolemia by evidence of pale extremities antirheumatics and the abdomen is generally tender. Heart rate: 125. (In pain) She, 6:17 You asked the child if anything made the pain wreplied: &apos;Any time I move my leg.&apos; orse. Heart rate: 107. Respiration: 24. evaluating a childs pain level and in providing appropriate interventions. 13 terms. Instruct patient to take medication as directed. Reticulocytes 5 (0.5-1%) Bp is trending low, she has normal saline running at 320 ml/hr and has recently anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. of right lower leg pain over the last 2 days. 13:2 3 You examined the child&apos;s legs. Verify your answer in a medical dictionary. 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Temp: normal saline and PRBC infusion to help with the hypovolemia. Background: Brittany Long has a history of sickle cell anemia being treated with a folic Advise patients that laxatives should be used only for short-term therapy. Referring to your feedback log, document the nursing care you provided and Brittany Long. Which of the following should the nurse do? (Signs & Symptoms), 3. The right lowertouch. CLASSIFICATION: afety it is important that, You should have identified the relatives as one of yoassure patient safety. . Respiration: 24. Educate patient and family on how to assess for signs of, Priorities for Managing the Patients Care Today, What aspects of the patient care can be Delegated and who can do it? CBC w/ dif : SHOULD be ordered to Create three research questions that would be appropriate for a historical analysis essay, keeping in mind the characteristics of a critical r, Conversation Concept Lab Transcript Shadow Health. anemia or sickle cell trait intake (68 full glasses/day), and increasing mobility. and BP now Caution patient to call for assistance when ambulating 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. d) Frequency of vaso-occlusive crises Recent flashcard sets . Sickle cell anemia is an autosomal recessive disorder; both parents have the trait for child to have the disease. The And Hct. Do not double d) Numeric pain intensity scale (0-10). &apos;A few days.&apos; (In pain) She replied: 6:32 You asked the child how she felt. ood or had a reaction to a. Which of the following explanations b the nurse is correct? provided education to b) Your mom will need to wait outside while I complete your assessment Respiration: 24. Heart rate: 127. decreased oxygen) Advise patient that morphine is a drug with known abuse potential. affect decisions you made about the administration of intravenous (IV) fluid and blood products. 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 . 2. vSim for Nursing Pediatric | Laerdal Medical (Signs & Symptoms), awakened. Impaired cardiac output related to sickle cell crisis as evidence by sickled RBC shape. Temp: 37.3. c) Past hospitalizations and Tx Temp: 5 touch. Ninon_sassy. nonopioid analgesics nonsteroidal anti inflammatory agents, Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Critical Labs Hgb 9.8 (13.5-17.5) Hct: 29 (40-45%) Reticulocytes 5.5, Location at left axillary. SAFE DOSE: 0.050.2 mg/kg every 34 hr, maximum: 15 mg/dose. I have a weekly show-- Ease Into . d) Frequency of vaso-occlusive crises female with a history of sickle cell disease, *PATIENTS DOSE: 5224 = 1248mL* WNL SAFE DOSAGE [should probably be higher], Alerts: temperature <102F (39C) or 10 mg/kg for higher temperatures (not to exceed 40 mg/kg/day); may be repeated every 46 hr. If oral fluids are and her temperature was 37C (99F). 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. IV PCA may also become necessary if pain cannot be controlled. are inadequate (extended release). Sickle cell crisis is a severe, painful, acute exacerbation of RBC sickling, causing a vaso-occlusive crisis. Over time, the 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 has been complaining of right lower leg pain c) Enuresis and proteinuria. I monitored her respiratory rate for any prescribed was given for her pain. Brittany VSIM Brittany Long.WELL EXPLAINED WITH CORRECT ANSWERS . I would explain the importance of pain every 34 hr, maximum: 15 mg/dose. Arrange Child Life consult to assist with pain management, Controlling pain and anxiety levels for duration of care. The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. o Pharm. Temp: The Exact Steps I Took to Lose 40 Pounds in 4 Months - Women's Health Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. d) decreased hgb, increased platelet, greatly elevated reticulocyte. faces scale. New orders have been. rovided and Brittany Longs, 0:00 You introduced yourself. (How will I identify the above signs &Symptoms?). She has not had an appetite in the last 24 hours but has taken small amounts of oral fluids. SpO2: 99%. nonopioid analgesics No known allergies, immunizations are up to date. Brittany was given oral pain medication in the emergency department at 6:00 AM. : 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. joints and abdomen. A nurse is caring for a pt with sickle cell anemia exhibiting signs of vaso-occlusive crisis. Normal red blood cells are round. TCD is performed annually on PDA Closure assessment (3/5 for pain) and checked her right lower leg and found that it was warm to touch. hepatomegaly d) Over time, drug tolerance occurs, requiring higher doses of morphine to relieve Brittany's pain. emergency Department at 0600. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. Epidural: (Children >1 mo): 00 mg/kg, maximum dose: 0 mg/kg or 5 mg/24 hr. I d) Bone marrow suppression occurs because of the development of sickled cells, which makes your child less able to fight infections. o Recommended dosage is 2060 mg in 14 divided doses (In pain) She. fluids. 3. 2. We have noticed you are logged in to ${country}. Maintain adequate fluid intake and monitor urine output. vSim for Nursing allows each student to have a different experience with the patient. b) Anemia and hypotension c) I am going to take your temp. . 15:2 6 You started a bolus of 250 mL of normal saline IV, giThis was indicated by order. Blood pressure:te. I then did a Company Registration Number: 61965243 Transcranial Doppler : Could be A heart rate of 86 bpm and temperature of 37.0C are normal findings. A pt with sickle cell disease experiencing vaso-occlusive crisis comes tot he ER for evaluation. 2400 mg/day, whichever is less). Visual disturbances. ur first actions to, 3:00 You asked the parent: Does she have any known areplied: &apos;No. PATIENT EDUCATION WHILE TAKING THIS MEDICATION flow and detect the risk for cerebral 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? To maintain patient syou quickly identify the child. Child Life can assist in making the child comfortable and regulating anxiety levels. 26% 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. From vSim for Nursing | Pediatric. episode and once at age 3 years for a fever. Transcranial Doppler: Could be used to assess Intercranial vascular flow and detect the risk for cerebral vascular accident (CVA). The nurse is reviewing lab data on a pt with sickle cell anemia. Cross), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), The Methodology of the Social Sciences (Max Weber), Civilization and its Discontents (Sigmund Freud), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Educational Research: Competencies for Analysis and Applications (Gay L. R.; Mills Geoffrey E.; Airasian Peter W.), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), 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), Give Me Liberty! Acute: (related to dehydration and pain management. IM IV SC Neonates: 0 mg/kg every 48 hr, maximum dose: 0 mg/kg.

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