Eva Madison simple (J. Reeves) PDF

Preview

Summary

Download Eva Madison simple (J. Reeves) PDF

Description

1 James Reeves

Pediatric Case 6: Eva Madison (Complex) Guided Reflection Questions

Opening Questions How did the simulated experience of Eva Madison’s case make you feel? It made me feel a little better completing my initial assessment before moving on to interventions. Describe the actions you felt went well in this scenario. I feel like taking the vital signs went really well this time. I get really nervous about doing a thorough assessment when I can see that the patient is in distress. I didn’t forget to leave anything out though before I completed treatment.

Scenario Analysis Questions1 EBP List in order of priority your initial nursing actions identified for Eva Madison based on physical findings and family interaction. Assess, Administer Fluids via IV, Reassess, Collect urine and stool samples for culture, educate parents and child regarding diet, and signs of dehydration/ hypovolemic shock. EBP

When initiating a fluid bolus for a dehydrated child, what type of fluid should be given and why?

Normal saline or 5% glucose in normal saline should be given until labs reveal electrolyte imbalances, if there are any.

EBP

What complications might Eva Madison face if her symptoms are not recognized and treated in a timely manner?

Hypovolemic Shock if the dehydration got too bad, also fluid electrolyte imbalance impaired nutrition if the vomiting and diarrhea continued, skin integrity could have been compromised from the diarrhea as well. PCC What measures should be initiated to decrease anxiety in Eva Madison’s 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.

2 James Reeves mother while simultaneously caring for Eva? Honesty and transparency regarding Eva’s Diagnosis and treatment, Therapeutic Communication S/QI

Reflect on ways to improve safety and quality of care based on your experience with Eva Madison’s case.

Complete a thorough assessment of the patient before beginning any interventions S/QI

What infection control measures should be taken in this case and why?

Contact precautions should be taken with this patient especially since I had to interact with bodily fluid that may be infected. The patient was not suspected of having a disease transmissible by air or droplets, nor was deemed immunocompromised. 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 – James Reeves caring for Eva Madison. Reporting in regard to continuing care for Eva’s diagnosis of dehydration B - Eva into the emergency room with a 3-day history of vomiting and diarrhea, an inability to tolerate oral fluids, and has not urinated since 2000 the day prior to admission. The patient weighed 21.8 kg 1 month ago at a well-child checkup and now weighs 20.5 kg. A saline bolus of 400ml was administered in the ER and I have started an IV of D5 ½. A stool and urine sample have been sent to the lab. A - Heart rate: 182. Pulse: Present. Blood pressure: 84/67 mmHg. Respiration: 31. Conscious state: Appropriate. SpO2: 94%. Temp: 37.2 C. Tenting is present, and mucous membranes are dry. R – I recommend ordering a CBC and a Basic Metabolic Panel to check electrolytes and Hematocrit, presence of infection, and Hydration status

Concluding Questions Reflecting on Eva Madison’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently? I would make sure to get the weight of the child. I forgot to get the weight during my assessment but that is the best indicator of dehydration in children. Describe how you would apply the knowledge and skills you obtained in Eva Madison’s case to an actual patient care situation.

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