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Maternity Case 1: Olivia Jones Guided Reflection Questions, Exams of Nursing

West Virginia Wesleyan CollegeNursing

Maternity Case 1: Olivia Jones Guided Reflection Questions

Typology: Exams

2023/2024

Available from 08/15/2024

jrinnovator
jrinnovator 🇺🇸

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Med C File
Maternity Case 1: Olivia Jones
Guided Reflection Questions
Opening Questions
How did the simulated experience of Olivia Jones’s case make you feel?
This simulation made me have more anxiety than usual. There was a lot of different things occurring and
the provider orders were bulkier.
Describe the actions you felt went well in this scenario.
I felt like although there were a lot of orders to follow, I was able to properly and efficiently complete
them.
Scenario Analysis Questions
1
EBP What are the indications that Olivia Jones’s preeclampsia has progressed?
Hyperreflexia, elevated blood pressure, severe headache, clonus, pitting edema, hypoxia,
epigastric pain, and abnormal lab results.
PCC What should the priority teaching for Olivia Jones include?
The priority teaching for Olivia Jones should include improving the understanding of her medical
condition and methods and means to manage her condition. Effective communication and
patient education increases the patient’s motivation to comply. Also, correctly identifying Olivia
Jones’ severe pain under her right breast from the decreased blood flow to her liver because of
her elevated blood pressure is vital. She thought she was having a heart attack, so educating her
about the correct cause of pain can decrease her anxiety.
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?
Indications of magnesium sulfate are the treatment of hypertension, prevention of seizures,
preterm labor. Patient education about magnesium sulfate should include why the medication is
being given, side effects of the medication, such as confusion, SOB, nausea, dizziness, abnormal
heartbeat.
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/
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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? This simulation made me have more anxiety than usual. There was a lot of different things occurring and the provider orders were bulkier. Describe the actions you felt went well in this scenario. I felt like although there were a lot of orders to follow, I was able to properly and efficiently complete them. Scenario Analysis Questions^1 EBP What are the indications that Olivia Jones’s preeclampsia has progressed? Hyperreflexia, elevated blood pressure, severe headache, clonus, pitting edema, hypoxia, epigastric pain, and abnormal lab results. PCC What should the priority teaching for Olivia Jones include? The priority teaching for Olivia Jones should include improving the understanding of her medical condition and methods and means to manage her condition. Effective communication and patient education increases the patient’s motivation to comply. Also, correctly identifying Olivia Jones’ severe pain under her right breast from the decreased blood flow to her liver because of her elevated blood pressure is vital. She thought she was having a heart attack, so educating her about the correct cause of pain can decrease her anxiety. 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? Indications of magnesium sulfate are the treatment of hypertension, prevention of seizures, preterm labor. Patient education about magnesium sulfate should include why the medication is being given, side effects of the medication, such as confusion, SOB, nausea, dizziness, abnormal heartbeat. 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/

T&C What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format. 23 year old female, 36 weeks of gestation, admitted to labor & delivery unit. She has been diagnosed with preeclampsia. Pregnancy has been normal until prenatal visit at 30 weeks. She has been on bed rest at home until prenatal visit today. Patient status – Heart rate: 111. Pulse: Present. Blood pressure 169/101 mmHg. Respiration: 22. Conscious state: Appropriate. SpO2: 91%. Temp: 37 C. EFM: Early deceleration. Fetal heart rate: 154. Patient complains of pain in the upper center of stomach and under right breast. Patient complains of headache, right across her forehead. Patient rates pain to be 5 out of 0-10 pain scale. Patient denies medication for pain at this time. Patient has moderate to severe pitting edema +3. Crackles at both bases of lungs upon auscultation. Deep tendon reflexes were very brisk, hyperreflexia, and with clonus, grades to +4. Patient reports her vision is blurred and she sees spots. Bladder scan showed 81 mL of urine. Foley catheter inserted under provider order. Palpation of uterus for contractions showed no contractions, fetal movement was felt, and uterine tone was moderate. Magnesium sulphate in sterile water 200mL/hr infused. IV site is dry, clean, and intact, with no presence of bleeding, redness, or infiltration. Patient education was provided about medical condition. Provider notified and is coming to see patient. Recommendation, continue to assess pain and monitor vital signs, implement 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? 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. Side rails up, suction equipment to the bedside, oxygen available, seizure precautions Concluding Questions Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain. I felt that I performed in this vsim well and even though there were a lot of orders to follow, I felt like I did them with knowledge and care. Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case to an actual patient care situation.