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Maternity Case 1: Olivia Jones (Core) Guided Reflection Questions

Opening Questions How did the simulated experience of Olivia Jones’s case make you feel? I felt okay with this vSim. I have found that every vSim changes the location of items you need, so it comes down to finding them each time. Describe the actions you felt went well in this scenario. I felt the head-to-toe assessment went well.

Scenario Analysis Questions1 EBP What are the risk factors for Olivia Jones and her baby if preeclampsia is not treated in a timely manner? If not treated in a timely manner, Oliva is at risk for preterm labor, placental abruption, eclampsia, organ damage, cardiovascular disease, HELLP syndrome, fetal growth restriction, and preterm birth. EBP

List the warning signs of hypertensive disorder in pregnant women.       

Headache that doesn’t go away Edema (swelling) Sudden weight gain Vision changes, such as blurred or double vision Nausea or vomiting Pain in the upper right side of your belly, or pain around your stomach Making small amounts of urine

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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. © Wolters Kluwer Health.

PCC

What should the priority teaching for Olivia Jones include? Bed rest, limited guests and be in a calm setting, more prenatal visits. Watch blood pressure, and vital signs. Drink 8 to 10 glasses of water, high protein diet.

T&C

What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format. S- 23-year-old African American female, G1P0 at 36 weeks of gestation. She has been diagnosed with mild preeclampsia and is admitted to the OB triage area for assessment and surveillance. B- Pregnancy has been unremarkable until routine prenatal visit today, where BP was 146/92 mm Hg, and a weight gain of 8 lb was noted since last prenatal visit 2 weeks ago. Ms. Jones presents with nausea and fatigue but denies headache, epigastric pain, visual changes, chest tightness, or abdominal pain; she also denies rupture of membranes, bleeding, or increased vaginal discharge. A- Ms. Jones states her rings do not fit anymore and she feels ''puffy.'' Her deep tendon reflexes are normal, +2. Protein dipstick is +2, negative ketones, negative glucose, and +1 dependent edema. Fetal HR, via Doppler in office today, was 130/min, and the baby was active. R- Bed rest, monitor liver function, kidney function, and platelets, fetal ultrasound, and nonstress test.

PCC

What communication techniques could be initiated to decrease the anxiety of Olivia Jones and her mother? Educate Olivia and her mother about preeclampsia, what treatments are being done, and what to look out for and report.

S

What safety measures should be initiated while Olivia Jones is in the hospital? Have oxygen ready at the bedside and set equipment to monitor blood pressure every 15 minutes, obtain doctor’s order for magnesium sulfate on standby if needed.

I

Consider what information on preeclampsia should be provided to Olivia Jones. Oliva needs to know all of the signs and symptoms of preeclampsia and know what to report to her doctor.

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

Concluding Questions Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain. The hardest thing about vSims is locating where the items you need are. I didn’t see where limiting stimulation was at first so I was able to find it faster the second time. Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case to an actual patient care situation. I know what signs and symptoms to look for and what measures need to be implemented.

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