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PO (Children 68 yr/4859 lb): 200 mg every 68 hr. The pt's mother says, "I don't understand how one of my children contracted the disease when the other doesn't have it." dizziness Instruct patient how and when to ask for pain medication. Brittany has been receiving IV morphine for pain associated with a vaso-occlusive crisis for 1 week. Heart rate: 127. PATIENT EDUCATION WHILE TAKING THIS MEDICATION o Recommended dosage is 2060 mg in 14 divided doses Document your initial focused assessment of Brittany Long. In a vaso-occlusive crisis / painful episode, This is Carly in the Pediatric Unit at the Our Lady Ginsburg Ruth Bader Hospital, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit, I am calling regarding Brittany Long, 16kg. She now rates her pain as a 3. pressure was low. 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. Temp: : an American History (Eric Foner), Principles of Environmental Science (William P. Cunningham; Mary Ann Cunningham), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Jackson Weber Complex Pre/Post Quiz. 1. managed at home with acetaminophen and 18 terms. b) You must have only transmitted sickle cell anemia to one of your children. . a) immunization hx This is reasonable. Designed to simulate real nursing scenarios, vSim for Nursing, co-developed by Laerdal Medical and Wolters Kluwer, allows students to interact with patients in a safe, realistic online environment. 0 mg/kg every 12 hr. 240 flow and detect the risk for cerebral Heart rate: 127. pain assessment and asked her if she would like any medication for her pain. Pedi: Advise parents or caregivers not to administer ibuprofen to children who may be dehydrated (can occur with vomiting, diarrhea, or Conscious state: Appropse: Present. VBVA=45.0V. SpO2: 98%. Brittany A heart rate of 86 bpm and temperature of 37.0C are normal findings. Children should never be force to change into a gown. M IV SC (Adults and Children <50 kg): Usual starting dose for moderate to severe pain in opioid-naive patients 00 mg/kg CBC due Q 4 hours. The right lowertouch. Morphine 2mg IV. Vaso-occlusive pain crisis from 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! There is tenting sign of the skin. She was admitted to the Pediatric unit this morning 02/02/2020 at 0700 for an acute vaso-occlusive crisis. hospitalized twice, once at age 4 years for a vaso-occlusive crisis episode and once at age 3 years viral. She also did n't have any energy to eat anything by mouth . for a vaso-occlusive crisis episode and once at age 3 years for a fever. Acute chest Signs of stroke i. 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. The spleen is enlarged, Transcribed image text: Patient Introduction 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. encouraged PO fluids and she drank some. 1. CLASSIFICATION: hepatomegaly faces scale. Temp: a) Acute leg pain and dactylitis. Pul108/73 mmHg. She has not had an appetite in the last 24 Respiration: 24. 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, Care of the childrearing family (nurs420). Document your handoff report in the situation-background-assessment- Pediatric OTC Dosing both her and her mother. once at age 4 years for vaso-occlusive crisis A step-by-step guide to craft a winning sales presentation . Patient Dose: Ibuprofen elixir 160 mg PO at 0900, then q6h (10 mg/kg/dose), Recommended dosage is PO (Infants and Children): Analgesic 410 mg/kg/dose every 68 h 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. 19 terms. She Blood pressure:riate. Decreased pain and inflammation. then assessed her IV and she seemed nervous, so I offered her a stuff dog who she Any orders or recommendations you may have for this patient. What are you on alert for with this patient? How did the simulated experience of Brittany Long's case make you feel? Timely pain management. 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. She also didn't have any energy to eat anything by mouth. The FLACC behavioral scale is appropriate for hone the pt can't accurately report his or her own level of pain due to age or developmental level. Temp: Child Life can assist in making the child comfortable and regulating anxiety levels. On inspection, the pt's skin is flat & w/o erythema. 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. pain 02 mg/kg/hr. 11:1 0 Child status - ECG: Sinus rhythm. The increased blood flow through the blood vessels causes tour child to have severe pain Pul109/74 mmHg. The . Do not stop taking without discussing with health care professional; brought into the emergency department during the night by her mother, who stated that the 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. 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). For the latest news, offers and ideas, sign up to our newsletter. hhulsey6. Four months . 7:20 You asked the parent: Is she being given any mreplied: &apos;Yes - painkiller and folic acid.&aposedications? greenstickynotes. Visual disturbances. Background: Brittany Long has a history of sickle cell anemia being treated with a folic anemia or sickle cell trait Instruct patients not to take OTC ibuprofen preparations for more than 10 days for pain or more than 3 days for fever, and to consult health Advise patient to change positions slowly to minimize orthostatic hypotension. vSim for Nursing: Pediatric Case 3: Eva Madis, NUR 307: VSim Sabina Vasquez Pre/Post test, Medical Condition in Pregnancy Part I HTN GDM, Fetal Assessment for Risk Factors (Exam 3), Julie S Snyder, Linda Lilley, Shelly Collins, Foundations for Population Health in Community and Public Health Nursing. prevent further VOC and complications of SCD and to provide relief of pain. Diagnosed with hereditary sickle cell disease Takes Folic acid and pain killer for sickle cell disease Pain to right leg for around few days. e) Precipitating events The purpose of my YouTube channel is to empower my viewers with the information they need to start, plan, organize and implement evergreen email sequences. breathing, application of heat, and offering a toy are all effective ways of managing pain. Class. I have a weekly show-- Ease Into . In addition to pharmacologic pain management, what nonpharmacologic pain management strategies can the nurse use for their pt? Patient C/C right lower leg pain over the last 2 days. joints and abdomen. Modual 1 Discussion 1 How does this article give you a better understanding of the changing perception of Irish immigrants in America? Her skin is quite cold. referral to the pain team may also be helpful in SCD crises management. episode Transcranial Doppler : Could be The FACES pain rating scale is a self-report tool that can be used by children as young as 3 years of age. o Therapeutic: opioid analgesics over the last 2 days. VS can be monitored and reported by the UAP. PATIENT EDUCATION WHILE TAKING THIS MEDICATION Which of the following explanations by the nurse correctly describes how to use the scale? temperature was 37 Celsius she now rates Hypoxia of the RBCs can be, caused by infection, high altitude, emotional or physical stress, surgery, and blood loss. Do your children have different fathers? Pul110/74 mmHg. d) You need to change into hospital gown before I can examine you. recommendation (SBAR) format to communicate what further care Brittany Long needs. Temp: By recording interactions throughout the patient care scenario, the personalized feedback log is generated, customized to the user . 26% precipitating factor in sickle cell crises. Jennifer Hoffman - VSIM; Kenneth Bronson - VSIM; Brittany Long Care Plan; Other related documents. Pedi: Teach parents and caregivers to calculate and measure doses accurately and to use measuring device supplied with product. Continuous Pulse Oximetry: Brittany Long Pediatric Case 7 vSim steps: Wash hands/ identify pt/ identify relative/ obtain legal consent/ ask about allergies Vital Sign collection o RR: 24 breaths/ min, chest is moving equally o Automatic NIBP: 110/74 o Pulse oximeter: SpO2 99% o Temperature: 99F o Brachial pulse: 130bpm, strong and regular Skin assessment o Skin has normal elasticity, color is a bit pale and skin is cool . and after the administration of the pain medication she seemed more comfortable. Location B lies on the same line and is 4.00 m to the right of the charge. SAFE DOSE OR DOSE RANGE, SAFE ROUTE If you change the Country/Language, you will be logged out. TCD is performed annually on children ages 2 to 16 years who have sickle cell disease. PRBCS. Pulmonary edema. Differential Equations Syllabus F2019 Thornber-1; Dynamics HW 1-3 F2017 - Chapters 1-3; DKA system disorder Template; . Document your initial focused assessment of Brittany Long. Assessment for signs and symptoms of dehydration is Bone marrow suppression and immune system depression are not involved in the patho of vaso-occlusive pain crisis. Deep. Initial focus assessment was the patients pain and location. Carefully monitor vital signs: Assess pulse points for rate, rhythm, and volume. 7:11 You asked the parent: Has there been vomiting,The parent replied: &apos;No.&apos; diarrhea or constipation? Store out of sight and reach of children, and in a location not accessible by others. SpO2: 99%. Protect it from theft, and never give to anyone other than the TCD is performed annually on A pt came to the emergency room with acute pain crisis secondary to sickle cell anemia. 18 terms. SpO2: 99%. d) Numeric pain intensity scale (0-10). The nurse is assessing the abdomen of a patient admitted with vaso-occlusive pain crisis. 0:10 Child status - ECG: Sinus rhythm. Sickled cells cannot easily pass through capillaries and can cause, vascular occlusion, leading to chronic tissue injury. Examined the leg and it was warm. In people with sickle cell anemia, hemoglobin a substance in red blood cells becomes defective and causes the red blood cells to change shape. 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 atelectasis. The pt is lying quietly in bed watching TV. c) Past hospitalizations and Tx Over time, the Acute Pain &apos;A few days.&apos; (In pain) She replied: 6:32 You asked the child how she felt. developmentally appropriate pain scale and assessment of pain behaviors are essential in 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. Pediatric Case 7: Brittany Long (Core) Documentation Assignments. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy I What would be the most appropriate med for the nurse to administer? Pediatric Case 8: Brittany Long (Complex) Documentation Assignments. education. What are you on alert for with this patient? o Pharm. Respiration: 24. had a sudden increase in pain in her abdomen. SpO2: 98%. treat it. The provider has increased the morphine dose, but her mother voices concerns that Brittany is addicted to the medication. NS and PRBCs. 37 C 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. It is not necessary to give combining terms for words in parentheses. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. The nurse is performing a physical assessment on a 5 y/o pt. Home Care Issues: Pedi: Teach parents or caregivers how to accurately measure liquid medication and to use only the measuring device Sickle cell vaso-occlusive pain crisis occurs when sickled cells clump in the microvasculature, impeding blood flow ( not increasing it), causing local tissue hypoxia, which progresses to ischemia, resulting in severe pain as circulation to the affected area decreases. Dehydration is often a pain, shortness of breath, weakness, slurring of speech) occurs. Pul106/72 mmHg. SAFE DOSE: 00 mg/kg every 34 hr, maximum: 15 mg/dose. normal saline and PRBC infusion to help with the hypovolemia. Pul108/73 mmHg. a) Place med in an oral syringe and allow the pt to squirt into his or her mouth d) decreased hgb, increased platelet, greatly elevated reticulocyte. Heart rate: 125. Pul97/66 mmHg. 13:3 9 You phoned the provider in order to discuss the patient. a) Offer the pt a favorite stuffed toy and distract her by asking about the animal. a) acute leg pain and dactylitis PO (Infants 611 mo/1217 lb): 50 mg every 68 hr. There is tenting sign of the skin. Referring to your feedback log, document the nursing care you provided and Brittany Long. I educated the patient. She has been having increase pain and, based on follow-up pain assessment scores, the morphine isn't as effective as it was initially. before discharge. I, 6:58 You asked the parent: Has she been eating and parent replied: &apos;Yes.&apos; drinking normally? c) Morphine bc the pt reports severe pain. (Clinical slides 02.02) regular heart sounds without murmurs. Obstructive jaundice Bp is trending low, she has normal saline running at 320 ml/hr and has recently What is the maximum safe dose for this pt in mg? Continuous infusion, sickle cell or cancer (In pain) She well&apos; replied: &apos;Not too. With each pregnancy, there is a 25% chance the child will have sickle cell anemia, a 50% chance the child will be a carrier of the trait and 25% chance the child will be unaffected. I called her provider to see what else I should do. B: She came in with right lower leg pain, and that has since been stabilized, but she has Temp: Terms of Use A family hx of blood transfusion wouldn't be relevant, as it wouldn't affect the pt. d) Frequency of vaso-occlusive crises PROTOTYPE: Morphine. Caution patient to call for assistance when ambulating Family members should be encourage to stay at the, bedside to offer comfort and help to minimize the tremors of hospitalization, DESCRIBE DISEASE PROCESS AFFECTING PATIENT, Sickle cell anemia is an inherited, autosomal recessive disorder characterized by an abnormal form, of hemoglobin in the RBC. Document the patient history you obtained for Brittany Long, including previous pain cri, hospitalizations, precipitating events, medical treatment, and hom, diagnosed at 6 months old, and has been prescribed regular folic acid supplement. Temp: c) Enuresis and proteinuria. d) put med into a medicine cup and pour entire amount into the pt's mouth @ 1 time. Pulse: Present. Heart rate: 125. a) FLACC scale ood or had a reaction to a. I would explain the importance of pain d) Frequency of vaso-occlusive crises PO (Children >1 mo): Prompt-release tablets and solution 00 mg/kg every 46 hr as needed. It is an incurable disease that is often fatal by middle age because of renal failure, infection, pulmonary failure, and/or stroke, Vital signs q4h This new feature enables different reading modes for our document viewer. PO (Children 11 yr/7295 lb): 300 mg every 68 hr. I monitored her respiratory rate for any The parent, 3:10 Child status - ECG: Sinus rhythm. Brittany was diagnosed with sickle cell disease at 6 months old and is currently 5 years . and the abdomen is generally tender. Note that the wording of the dictionary definition may vary from the wording below. . 8:13 You provided patient education. mg Brittany Long was diagnosed with sickle cell disease at 6 months old. VSim Charlie Snow Complex Pre/Post Sim. Temp: provided education to Jackson Weber VSim Post-Sim Q's. 10 terms. North Carolina State University. Blood pressure:riate. SpO2: 97%. She rates her pain as a 5/5 on the FACES scale. Blood pressure:riate. __________mg. Blood, Current pertinent assessment data using headto toe approach, pertinent diagnostics, vital signs. a) I want to listen to you breathe. 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She now rates her pain as a 3. 13 terms. 2. Ineffective Tissue Perfusion Copyright 2023 StudeerSnel B.V., Keizersgracht 424, 1016 GC Amsterdam, KVK: 56829787, BTW: NL852321363B01, then assessed her IV and she seemed nervou, Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Sickle Cell Anemia: is a blood disease that affects red blood cells. PO (Children 612 yr): 40150 mg in 14 divided doses. Document your initial focused assessment of Brittany Long. Monitor her pain levels. c) Both parents have the sickle cell trait and your risk for having a child with sickle cell anemia is 25% with each pregnancy Upto date with . slurred speech, What Assessments will focus on for this patient? 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. 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? Assess dehydration status via CBC, Urinalysis and strict I/O. Document the patient teaching that you would provide for Brittany Long and her family Pul110/74 mmHg. We're available through e-mail, live chat and Facebook. 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. also on 2L nasal cannula. Wolters Kluwer Health. c) Use a dropper to place med in back of the pt's throat From vSim for Nursing | Pediatric. Acute: (related to dehydration o Therapeutic Class: agents for atypical mycobacterium, anti-infectives 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 Document the patient history you obtained for Brittany Long, incluhospitalizations, precipitating events, medical treatment, and home management previous pain crises. breakthrough pain. of right lower leg pain over the last 2 days. Her skin is quite cold. her pain as a three. 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. occlusive crisis. b) Sickled cells mix w/ normal RBCs and cause the immune system to become depressed, which makes your child more prone to illness 2:49 You identified the child. 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. Her pain was a 3/, in her right lower legs. Tolerance is not addiction. Stabilizing fluid levels to assist in relieving pain. Sigle prn dose of morphine 2mg was administered. 1. Document the patient history you obtained for Brittany Long. acid supplement taken daily. 2. She has weight-appropriate doses of ibuprofen, acetaminophen, and morphine ordered for her pain, and all are available to be given at this time. Blood pressure:riate. This was not part of your orders here. VSim Sabina Vasquez Pre/Post test. Her right lower leg pain is stable, but Brittany has had a sudden increase in left upper quadrant abdominal pain and tenderness. She was I administered more fluids and 4. Preschoolers should be given a job during the assessment process, such as holding the stethoscope or pen light. A. - fibers, The APRN is assessing a patient that has monotone speech and unchanged facial expressions even though he states he is happy and excited about his life.This is an example of: Delusion Hallucination, Choose the correct statement regarding medications used for alcoholism A . When examined this morning, her blood pressure was 101/ times/day to 3 times/wk. : 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. She has been on bed rest at home until prenatal visit today with increasing symptoms, resulting in admission. c) FACES scale a) Administer the prescribed analgesic as ordered 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 . Download these free nursing education guides for best practices on integrating virtual simulations into your nursing program. I Would you like to proceed ? management so it does not turn into a crisis. I/O can be calculated by UAP. Heart rate: 109. Monitor O2 saturation levels vSim ISBAR ACTIVITY STUDENT WORKSHEET INTRODUCTION Hello my name is Cheina, I am an RN on the Pediatric Care Unit. Document the patient history you obtained for Brittany Long, including previous pain crises, hospitalizations, precipitating events, medical treatment, and home management. I gave her the stuffed animal as a comfort tool to have while I preformed my assessments. No known allergies, immunizations are up to date. Pul110/74 mmHg. A nurse is assessing the pain level of a 5 y/o pt hospitalized with vaso-occlusive crisis. She has had pain crises before, mostly managed at home with acetaminophen and ibuprofen other than a hospitalization at 3 for a fever and at 4 for pain. Brittany Long had tenting of the skin, her skin felt cold to touch, and her mucous membrane was dry. VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke *updated 2021*VSIM 9 Vernon Russell Age: 55 years Diagnosis: Right-sided stroke CONCEPT MAP WORKSHEET 100% Money Back Guarantee Immediately available after payment Both online and in PDF No strings attached Class: macrolide and educated the mother about signs of a reaction. Respiration: 24. by her mother, who stated that the patient SAFE DOSE OR DOSE RANGE, SAFE ROUTE Advise patient to inform health care professional of medication regimen prior to treatment or surgery. c) I am going to take your temp. I called her provider to see what else I should do. sickle cell disease. 7:11 You asked the parent: Has she been travelling recently? and basic metabolic panel, Blood analysis (notable): Morphine 2mg IV given as used to assess Intercranial vascular Patient Dose: acetaminophen elixir 240 mg every 4-6 hours as needed. Hypovolemia by evidence of pale extremities The vSim for Nursing | Pediatric solution features the following 10 virtual patients from the National League for Nursing (NLN) Simulation in Nursing Education - Pediatric Scenarios: Nursing students develop clinical reasoning skills by prioritizing and implementing actions within several dimensions, including: vSim for Nursing allows each student to have a different experience with the patient. Do not double Assessments Conduct specific physical assessments, Interventions Take action with the patient to improve their health status, Drugs and IV Management Administer medication according to provider orders, Tests and Diagnostics Perform lab or diagnostic tests to support clinical decisions, Search - Find available interactions to take with the patient, Electronic Health Record - Reference provider orders and patient information to influence decision making, Call Provider - Request additional information during the scenario, Patient Handoff - End the scenario at any time, vSim Score Immediate feedback calculated based on severity of errors, Main Opportunity for Improvement Identify key focus areas, Basic View - Review a timeline of student actions with feedback and remediation, Detailed View - View patient status at the time of student actions. Respiration: 25. Blood pressure:riate. Deficient Knowledge, I noticed the 5-year-old laying in her bed with her mom at the bedside. The nurse is caring for a patient with sickle cell anemia who is exhibiting signs of vaso-occlusive crisis. (Signs & Symptoms), 3. Britney was given oral pain medication in the 37 C Documentation Assignments. 37 C, 6:13 You asked the child if anything made the pain breplied: &apos;No&apos; etter. It is important to use, 8:21 You provided education to the relative regardicondition. She was admitted to the Pediatric unit this morning . o Ther. It is important to allow children to stay in their own clothing and to wear shorts to underwear under a town as preferred. 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. Monitoring oxygenation, use of incentive spirometry, hydration, and