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Maternity Case 1: Olivia Jones Guided Reflection Questions

Opening Questions How did the simulated experience of Olivia Jones’s case make you feel? I was very uncomfortable and afraid. I never was in a situation like that before with an expectant mother as a patient. I was nervous because the patient kept saying that she would throw up and I wasn’t sure what to do. Describe the actions you felt went well in this scenario. Patient was cooperative with my assessments even if she didn’t feel well. Scenario Analysis Questions1 EBP What are the indications that Olivia Jones’s preeclampsia has progressed? PCC

Hyperreflexia elevated blood pressure severe headache clonus edema hypoxia epigastric pain abnormal lab results. What should the priority teaching for Olivia Jones include?

The priority teaching for Olivia Jones should include educating on magnesium sulfate and its possibility for induced labor or c-section if indicated. PCC/I Olivia Jones was placed on magnesium sulfate for treatment of her preeclampsia. What are the indications for this drug, and what should be taught to the patient regarding side effects? Magnesium sulfate are the treatment of preeclampsia , prevention of seizures, preterm labor. Patient education should include why the medication is being given. Side effects include: 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.

- confusion - SOB - nausea - dizziness - cardiac dysrhythmia. T&C

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

S- Olivia jones is 23-year-old African American female, G1PO, 36 weeks of gestation, admitted for assessment and monitoring. B- Normal pregnancy until week 30 when BP was assessed high at 156/91 mm Hg. Signs of preeclampsia and proteinuria. Pt recommended reduced activity, bed rest and reduce stress. Symptoms increased and she was admitted today. Patient gained 3Ibs since last week. A- VT: BP 173/103mmHg, 170/101 mmHg, 168/103mmHg. P 114. 116. R23. Temp 37 C. SpO2 95%. pain 4/10. Pt has pitting edema bilat of lower extermities +3, nonproductive cough, crackles at base of both lungs, fata heart rate 154, hyperreflexia graded to a +4, deep tendon reflexes were brisk. She had HA, nausea, feel as she wants to throw up and epigastric pain. R- Assess pain and monitor vital signs regualry. Keep seizure precautions. keep patient on strict bed rest and prepare for possible delivery. S

What safety measures should be initiated while Olivia Jones is in the hospital?

Oxygen administration available, suction near by, seizure precautions, prevention of falls

S/QI

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

Checking the patient vital signs, assessing fetal hear rate, implimenting safety and seizure precautions . Concluding Questions Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain. I would make be more confident in my actions and calmer as I would know what are the appropriate stps to follow in this case. Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case to an actual patient care situation.

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

I would provide the best care I can and manage my assessment time appropriately. I would make sure pt provide my patient with emotional comfort measures and follow doctor’s orders in the same time.

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