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Maternity Case 02 Olivia Jones Complex GRQ
Obstetrical Nursing With Clinical (NUR 350)
Denver College of Nursing
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Maternity Case 2: Olivia Jones (Complex)
Guided Reflection Questions
Opening Questions How did the simulated experience of Olivia Jones’s case make you feel?
The simulation definitely made me think about all the assessments that I needed to perform. I did miss some things the first time, but after evaluating what it was that I was missing it was easier the second time.
Describe the actions you felt went well in this scenario.
I think the administration of magnesium sulfate went well and in addition the assessments that were performed after such as her RR, breathing, BP, DTRs, and additional questions that would help to make sure she was not experiencing toxicity.
Scenario Analysis Questions 1 EBP What are the indications that Olivia Jones’s preeclampsia has progressed?
She had gained weight and was exhibiting +2 bilateral edema, DTRs were +4 with clonus. Her BP was also a lot higher than her 30-week BP indicating that it was just worsening.
PCC What should the priority teaching for Olivia Jones include?
Priority teaching for Olivia would include ways to manage her prognosis and determining when her condition is worsening based on s/s. Education and rational on taking magnesium sulfate would also be important. As well as explaining the possibility for c-section if things get super complicating.
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 is given to patients with severe preeclampsia to prevent seizures during the pregnancy and or delivery. Side effect include rash, itchiness, severe dizziness, and the possibility of excessive sweating.
T&C What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format.
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: qsen/
From vSim for Nursing | Maternity. © Wolters Kluwer Health.
Olivia Jones is a 23-year-old female G1P0 at 36 weeks of gestation admitted to L&D for assessment and monitoring due to diagnosis of severe preeclampsia. She was placed on bedrest at 30 weeks of gestation because of elevated BP, proteinuria, and development of mild preeclampsia. She arrived with increasing symptoms and a weight gain of 3 lbs, +4 protein dipstick, negative ketones, negative glucose, + dependent edema, and facial puffiness. Pt. is experiencing nauseous, fatigue and headaches not relieved by acetaminophen. Pt. vitals BP: 173/104 HR:114 RR: 22 SpO2: 90% T: 99F FHR: 157. Recommend continuing to monitor pt. and baby and possibly inducing labor to prevent complications.
S What safety measures should be initiated while Olivia Jones is in the hospital?
Seizure precautions, reduce stimuli, have oxygen and suction at bedside, and constant monitoring of the patient and baby.
S/QI Based on your experience with Olivia Jones’s case, reflect on possible nursing actions for enhanced safety and quality improvement.
Frequently assessing the patients’ vitals, LOC, DTRs, and symptoms to ensure the patient is being well taken care of and staff can intervene as needed. It is also important to for medication administration as ordered.
Concluding Questions Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain.
I would make sure to complete all the needed assessments after administering magnesium sulfate and remember to educate the patient on the rationale for why we are giving her magnesium sulfate.
Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case to an actual patient care situation.
I feel like I know how to better assess and monitor a patient with preeclampsia. This is such a common complication of pregnancy and I know that I would more than likely have a patient with this condition in the field and I know what I need to do to take care of them properly.
From vSim for Nursing | Maternity. © Wolters Kluwer Health.
Maternity Case 02 Olivia Jones Complex GRQ
Course: Obstetrical Nursing With Clinical (NUR 350)
University: Denver College of Nursing
