Maternity Case 3: Amelia Sung PDF

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Guided reflection questions for V-sim case study: Amelia Sung...

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Maternity Case 3: Amelia Sung Guided Reflection Questions

Opening Questions How did the simulated experience of Amelia Sung’s case make you feel? 

This time I felt more comfortable doing the simulation because I got an idea of what to expect but it was a knew experience to me so I didn’t pass until the third time which is fine because I learned so much about shoulder dystocia.

Describe the actions you felt went well in this scenario.  

Assessing the patient and prioritizing interventions related to non-reassuring FHR. Calling the charge nurse and NICU team and assisting the provider with the delivery.

Scenario Analysis Questions1 EBP What risk factors specific to shoulder dystocia were identified in Amelia Sung’s case? -

Prolonged second stage of labor, estimated fetal weight of 4000 gm, maternal diabetes (macrosomia),

PCC/I Prioritize your nursing actions for Amelia Sung based on your assessment. -

EBP

Stay calm and immediately call for additional assistance (extra nurses, charge nurse, NICU team). Change the mom’s position into McRoberts position. Apply suprapubic pressure to help push the anterior shoulder under the symphysis pubis. Encourage the patient to push during contractions to help accomplish the birth Provide the patient encouragement and support to reduce anxiety. Document the time the head emerges, time maneuvers are implemented, and the time body/shoulder emerge. Hand the baby to the charge nurse for physical examination for any fractures of the clavicle, brachial plexus injuries and asphyxia.

List potential problems for Amelia Sung and her baby related to the shoulder dystocia.

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 | Maternity and Pediatric. © Wolters Kluwer Health.

T&C -

Fetal injury can result from asphyxia related to delay in completing the birth or by trauma from the maneuvers used to accomplish the birth. Permanent fetal damage such as brachial plexus can result from intrauterine forces during second stage of labor. Maternal postpartum hemorrhage and rectal injuries. List the interprofessional health care team that should be involved in Amelia Sung’s case. Health care provider, NICU team, charge nurse, extra nurses, anesthesia specialist.

S/QI/I Consider what points might be included in a safety checklist for shoulder dystocia. -

Prompt action by the nurse must ensue upon the announcement of shoulder dystocia. time of delivery of the head and delivery of the body should be less than 6 minutes to prevent irreversible fetal damage. Having the NICU team and charge nurse ready to allow for immediate interventions and save the baby.

Concluding Questions Reflecting on Amelia Sung’s case, were there any actions you would do differently? Explain. -

Nothing, all the actions in this simulation were effective and needed.

Describe how you would apply the knowledge and skills that you obtained in Amelia Sung’s case to an actual patient care situation. -

I learned a lot from this case scenario about shoulder dystocia and the assessment findings that would indicate this problem and the interventions needed to prevent harm for the baby and the mom. I feel I’m more confident about this complication now after doing this case study that I can prioritize care for a real patient going through this knowing how to act quickly and stay calm at the same time.

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