Case02 GRQ - Maternity Case 2: Brenda Patton Guided Reflection Questions PDF

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Maternity Case 2: Brenda Patton Guided Reflection Questions...

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Maternity Case 2: Brenda Patton Guided Reflection Questions Opening Questions How did the simulated experience of Brenda Patton’s case make you feel?

This case was actually the easiest of those that I took and it was my first simulation. However, I still think that in a real situation, I believe that I can be more sensitive and effective with communication and care providing. Describe the actions you felt went well in this scenario.

I felt well to myself and did the assessment up to the point that we did in reality (assessment, pain management, comfort level - therapeutic communication and education, repositioning ). Scenario Analysis Questions1 EBP What complications can occur if group B streptococcus is not treated?

Group B strep infection can lead to life-threatening complications in infants, including Pneumonia; inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis); infection in the bloodstream (bacteremia); bone and joint infections; endocarditis; skin infection. PCC

What should be included in the priority teaching for Brenda Patton?

Education about the current condition (GBS positive, ruptured membrane) and what we will do about it (antibiotic administration to keep baby safe and healthy (it will not harm the baby), VS assessment) T&C

What key elements would you include in the handoff report for this patient? Consider the situation-backgroundassessment-recommendation (SBAR) format.

Brenda Patton is an 18-year-old Caucasian female, G1P0 at 38 2/7 weeks of gestation, admitted to the labor and birthing unit for labor assessment. The patient states that her water may have broken earlier this morning, and she thinks she is in labor. AmniSure was positive. Vaginal exam reveals 50% effacement of the cervix, cervical dilation 4 cm, and fetus at -2 station. The lab report indicates that the patient's group B strep vaginorectal culture taken at 36 weeks was positive. The patient wishes to have a natural birth without medication. The provider has been notified, and prenatal records have been pulled. Admission intrapartum orders have been initiated, initial labs have been drawn, and a saline lock has been placed in her forearm.

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 and Pediatric. © Wolters Kluwer Health.

Heart rate: 89. Pulse: strong, 90 per minute, and regular. Blood pressure: 119/71 mmHg. Respiration: 19. A&O x4. SpO2: 98%. Temp: 37 C orally. Fetal heart rate: 140. Pain assessment 2/10 between contractions. Does not want anything for pain. No allergic to anything. No obvious airway obstruction; normal elasticity of the skin; the color is normal, and she is not sweating; no signs of edema. Leopold's maneuvers were performed. The fetus is in a longitudinal lie, in vertex presentation. The uterus tone was soft between contractions. Regular contractions with moderate intensity had started. Contractions were approximately 4 minutes apart and lasting 50 seconds. The deep tendon reflexes were normal. Graded to +2. The IV site had no redness, swelling, infiltration, bleeding, or drainage. The dressing was dry and intact. Started a piggyback infusion of 5000000 IU of penicillin IV. The patient's boyfriend is present, and she has phoned her mother to inform her of her admission. S/QI

Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for enhanced safety and quality improvement.

Here in vsim, we do not have close communication. It is still a program. In real life, communication is an essential part of nursing care (at least how I see it). I would love to communicate closer, ask about a concern, worries, future plans, happy moments in the past (all of it related to pt goals and mental stability). Here in the simulation, along with the screen, we look like robots; yes, it is important to provide education and support, but what does it mean (how can I report it?): "Ok" as pt reply to what I have been done as a nurse? Anyway, I did my pt education (condition, possible intervention), explain my steps and why I did them; administered medication that was prescribed as well as fulfilled the doctor's orders. Concluding Questions Reflecting on Brenda Patton’s case, were there any actions you would do differently? Explain.

I do not think that I will do something better right now. I did "head to toe assessment" and VS as I step in the room, it is how I was told. Again, by being lockdown from the real experience right now I'm studying some patterns to act. I'm sorry, but my view on clinical practice has just "limited tunnel view" due to minimal real observation and communication. Describe how you would apply the knowledge and skills that you obtained in Brenda Patton’s case to an actual patient care situation.

Pretty much the same: HH, Introduction, pt identification, Assessment (auscultation, palpation, percussion (if needed)), IV assessment, pain assessment (location severity, description, wishes pain medications). Following doctor's orders, education, therapeutic communication.

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