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Nursing And Healthcare V: Family Health [Lec] (NURS 472)
Towson University
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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?
This simulation was very hectic and made me feel nervous. There were many things that needed to be done to help the patient in a limited amount of time. The patient was very uncomfortable, and I was just trying to do my best to help her and alleviate her pain and stress. However, after completing it I felt better because I now know what to do to help a patient in a similar scenario in real life.
Describe the actions you felt went well in this scenario.
I felt that I did the medication administration and the pain assessment well. I am familiar with magnesium sulfate, and I was able to correctly calculate the ordered dose, and got it checked by another nurse. Additionally, I know how important a pain assessment is when treating a patient, so I made sure to be very through when conducting this.
Scenario Analysis Questions 1 EBP What are the indications that Olivia Jones’s preeclampsia has progressed?
There were many indications that Olivia’s preeclampsia had progressed. Indications include edema in the lower extremities, crackles in her lungs, low platelets, clonus deep tendon reflexes, epigastric pain, headache and vision changes, and high blood pressure with low oxygen saturation.
PCC What should the priority teaching for Olivia Jones include?
The priority teaching for Olivia is her plan of care including the rationale for the administration of magnesium sulfate and the possibility of induced labor/emergency 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?
The indications for magnesium sulfate include the prevention of preeclampsia progressing into seizure activity and progressing into eclampsia. The side effects for this medication can include GI upset (nausea/vomiting, diarrhea), and cardiac dysrhythmias.
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From vSim for Nursing | Maternity. © Wolters Kluwer Health.
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 a 23yo African American female at 36 weeks’ gestation and was admitted for monitoring due to preeclampsia.
B: Pt had an elevated BP at around 30 weeks and began to develop mild preeclampsia with increasing symptoms.
A: Pt has +3 pitting edema bilaterally in the lower extremities, BP of 166/99, crackles at the base of both lungs, DTR were +4 and brisk with clonus, patient complains of epigastric pain, nausea, and vision changes.
R: Initiate seizure precautions, reduce stimuli in the room, administer magnesium sulfate, continuously monitor blood pressure, educate patient on possibility of induction or c-section.
S What safety measures should be initiated while Olivia Jones is in the hospital?
Seizure precautions should be initiated for Olivia, which includes padding the side rails of the bed, having oxygen and suction available, reducing stimuli, and continuously monitoring blood pressure.
S/QI Based on your experience with Olivia Jones’s case, reflect on possible nursing actions for enhanced safety and quality improvement.
Checking the patients’ vital signs frequently, assessing FHR often, implementing seizure precautions if indicated, and providing comfort measures are nursing actions that enhance safety and quality improvement for the patient.
Concluding Questions Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain.
In my first scenarios I did not do patient education, and in one scenario I drew the patients’ blood which was not indicated. I drew the blood to check for electrolyte levels, but there was no order to do so. For the patient education, it is necessary to tell the patient the rationale for certain interventions such as medications, so they can understand what is happening to them and why they need certain measures in place.
Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case to an actual patient care situation.
From the things I learned in this simulation, if I encounter a preeclamptic patient in the future I will know to complete a head-to-toe assessment, check the patient for edema, monitor vital signs frequently, and ask the patient if they are experiencing epigastric pain or visual changes. I will also know when to administer magnesium sulfate, and when to educate the patient on the disease process and the possibility of induced labor/ emergency c-section if indicated.
From vSim for Nursing | Maternity. © Wolters Kluwer Health.
Vsim reflection
Course: Nursing And Healthcare V: Family Health [Lec] (NURS 472)
University: Towson University
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