Charlie Snow VSIM Guided Reflection PDF

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Guided reflection questions and answers for the Coursepoint VSIM simulation for Charlie Snow....

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Pediatric Case 10: Charlie Snow (Complex) Guided Reflection Questions

Opening Questions How did the simulated experience of Charlie Snow’s case make you feel? This simulation felt uncomfortable to me in some ways. It felt frustrating in the beginning because here is a child who is having difficulty breathing and can easy decline rapidly, but I had to do steps before I could help him like wash my hands, obtain consent, identify the child, and identify the family. Of course, those steps need to come first, but it can feel overwhelming in such a serious situation. Discuss the actions you felt went well in this scenario. I think overall, the steps taken in this scenario went well. I felt like I could more easily identify what I had to do in this scenario better than the other ones because it was easier. It was kind of refreshing to have a patient I could work realistically with instead of other ones where I need to help deliver a baby and I’m clueless. Scenario Analysis Questions1 EBP List in order of priority your initial nursing actions identified for Charlie Snow based on physical findings and family interaction. The immediate interventions in this simulation was to change the patient’s bed position and give oxygen via nonrebreather because he complained of difficulty breathing. Then I need to ask the patient and the family about his medical history and symptoms, take vital signs including heart and lung auscultation, and assess Charlie’s pain using FACES. EBP

What complications might Charlie Snow face if symptoms are not recognized and treated in a timely manner? If the anaphalaxis is not treated immediately, Charlie’s breathing could very possibly become completely restricted. With the absence of his airway, he will die unless interventions can be applied quickly.

EBP

Why was a glucocorticosteroid administered in this case? Would it have been appropriate to administer albuterol in this case? Why or why not?

1 The 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 | Pediatric. © Wolters Kluwer Health.

Pediatric Case 10 Charlie Snow (Complex) Guided Reflection Questions Albuterol does not apply and will not work in this simulation because Charlie is not having an asthma attack. His breathing is restricted, but it is because of an immunological response to an allergen. A glucocorticosteroid is given to help reduce the inflammation that is restricting Charlie’s airway. PCC

What communication techniques could be initiated to decrease the anxiety of Charlie Snow’s aunt? This is an emergency situation, and I do need to work quickly with Charlie’s care, but I would still make it a priority to explain to Charlie’s aunt about the assessments and interventions that I am performing. Her anxiety is likely to be reduced if she can understand what I’m doing and why. This includes the medications I am giving him. I would also reassure her that I am going to help her make an action plan so that they are prepared in case this situation ever happens again.

S/QI

Reflect on ways to improve safety and quality of care based on your experience with Charlie Snow’s case. To improve safely and quality of care in this scenario, the assessment must be done much quicker in a real-life case like this. Vsim does not accurately portray the urgency of this situation at all, even as Charlie yells out that he felt like his throat was closing. It took too long before interventions could be made to help Charlie and address his anaphylaxis.

S/I

Because Charlie Snow is accompanied by his aunt and not by a parent, what legal matter must be considered before performing treatment? Charlie’s aunt’s identity must be identified and confirmed. Then, she will need to sign a consent form for the hospital to give treatment to Charlie.

T&C

What role do you feel Charlie Snow’s guardians and parents have as members of his health care team? (Explain your answer.) Charlie’s aunt clearly has a very prominent role in his life. She was informative about Charlie’s health history and present illness and is clearly heavily involved. She recognized the seriousness of Charlie’s situation and brought him to the ER herself. Charlie’s parents are overseas in the military, so they are likely gone for many months at one time. Charlie’s aunt is clearly his parental figure while his parents are away.

T&C/I What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format. S: Charlie Snow is a 6-year-old male who presented to the ER with tachycardia, mild stridor, and dyspnea. His aunt and uncle report that he accidentally ate a cookie containing peanuts, and he has a peanut allergy. When he began having difficulty breathing, they brought him here. Charlie

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

Pediatric Case 10 Charlie Snow (Complex) Guided Reflection Questions received 0.3mg of epinephrine 1:10000 IV, 25mg diphenhydramine IV, 20mg ranitidine IV, 10mg methylprednisolone IV, and 420mL normal saline IV over 30 minutes. B: Charlie is allergic to peanuts, dyes, and perfumes. A: Charlie’s most recent vital signs were heart rate: 202, respiration rate: 13, temp: 37.1C, SpO2: 99%, BP: 169/137 mmHg. R: Continue to monitor Charlie’s vital signs regularly and be vigilant for any signs of adverse effects to the medication he was given.

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

Pediatric Case 10 Charlie Snow (Complex) Guided Reflection Questions Concluding Questions Reflecting on Charlie Snow’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? Reflecting on Charlie’s case, like I mentioned earlier, I would assess Charlie and question his aunt with much more urgency than the VSim allows. Charlie’s situation is very urgent. I need to remember to have his aunt sign a consent form. The first run through in this simulation, I gave Charlie 20mL normal saline instead of 420mL, so I made sure to fix that the next time. Describe how you would apply the knowledge and skills that you obtained in Charlie Snow’s case to an actual patient care situation. I kind of feel like the simulation gave an accurate portrayal of an anaphylactic shock scenario, except for the lack of urgency. I feel as though I would have done the same interventions.

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