Brenda Patton Guided Reflection PDF

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Maternity Case 4: Brenda Patton (Complex) Guided Reflection Questions Opening Questions

How did the simulated experience of Brenda Patton’s case make you feel? I liked this particular VSim. I felt that this patient was easier to manage than other patients in the past. She hadn’t been in a lot of pain, didn’t have any allergies, and she wasn’t rude. I felt empathetic to her because she was so young and was experiencing an infection on top of getting ready to give birth. It must have been a big moment for her. Describe the actions you felt went well in this scenario. I think providing comfort for the patient went well in this scenario. Providing comfort is always important, but I think it was especially important for a young woman who is going through such a big moment in her life like having a baby. So, I felt especially compelled to check in on her pain levels, see how she was feeling, and comfort and educate her. Scenario Analysis Questions1

EBP

Based on the initial assessment of Brenda Patton, what findings did you find concerning? The first thing that stood out to me was that her lab culture had tested positive for GBS and had membrane ruptures. She also wanted to have a natural birth without medication, so I was concerned about the newborn’s risk for infection in addition to my patient’s pain level. PCC Brenda Patton stated that she would like to labor free of medication. What are some techniques that could be used to help her with her pain? I would try a variety of things such as putting on music that either the patient enjoys or is relaxing. I would try to make a relaxing environment around her with the music like dimming the lights and teaching her deep breathing exercises. If she’s able to, she could try to walk around the room or try using pregnancy balls. T&C What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format. Situation: The patient’s name is Brenda Patton, an 18-year-old female admitted for labor assessment. DOB 01/06/2002. Patient states her water may have broken this morning and she thinks she’s in labor. Vaginal exam reveals 50% effacement of cervix, cervical dilation 4cm, and fetus at -2 station. Background: Patient is diagnosed with rupture of membranes and labor assessment. Vaginorectal lab culture positive for B strep. The patient wishes to have a natural birth without medication. Patient status - Heart rate: 91. Pulse: Present. Blood pressure: 121/72 mmHg. Respiration: 19. Conscious state: Appropriate. SpO2: 98%. Temp: 37 C. EFM: Baseline. Fetal heart rate: 140. Patient states she has no allergies. A piggyback infusion of 5,000,000 IU of Penicillin IV was started at 8:07 as indicated by order. 1The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/ From vSim for Nursing | Maternity. © Wolters Kluwer Health.

Assessment: Patient may be in active labor. Contractions are 4 min apart, lasting for about 50 seconds. Patient’s pain is about a 2 in between contractions. Deep tendon reflexes normal. Recommendation: Patient should continue to be monitored for further contractions and delivery. Provider should be notified of patient’s lab culture results. Continue to comfort and educate the patient regularly, involving the patient’s partner. Monitor patient for signs of improvement with infection. Monitor patient and fetal vital signs. S/QI

Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for enhanced safety and quality improvement. I think I was surprised to see only one nurse in the room with the patient at this stage in her pregnancy. She was having contractions and dealing with a serious infection, so I think more medical staff would be necessary and beneficial here. I would also have further educated the patient on ways to help improve pain management since she does not want pain medication.

Concluding Questions

Reflecting on Brenda Patton’s case, were there any actions you would do differently? Explain. One thing I realized after the simulation was over was that I could not address this patient’s partner. He probably had questions and concerns and was likely very worried about my patient, so I wish I could have been able to incorporate communication with him. It likely meant a lot to my patient that he was present, and she deserves to have a partner who is informed and put at ease because then he could be an even better support system for her through this delivery. Describe how you would apply the knowledge and skills that you obtained in Brenda Patton’s case to an actual patient care situation. Again, this simulation definitely stressed further the importance of keeping your patients comforted and informed about everything. Having a baby is one of the biggest moments of someone’s life, so I think it’s especially important here. I also learned the seriousness of GBS on both the mother and the newborn baby. I had felt a sense of urgency to administer Penicillin to my patient in order to decrease the newborn’s risk of infection.

From vSim for Nursing | Maternity. © Wolters Kluwer Health....