Sadiksha Regmi

Maternity Case 1: Olivia Jones (Core)

Guided Reflection Questions

Opening Questions
1. How did the simulated experience of Olivia Jones’s case make you feel?

Olivia is the first patient on NLN V SIM. I found maternity v sim is little different than the v
sim we did for fundamental & peds. I was so confused at the beginning I did this simulation for
three times. Overall, it went well.

2. Describe the actions you felt went well in this scenario.

I think assessment part went well for me like head to toe assessment, taking vital signs.

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 preeclampsia is not treated on time, she might get seizure, stroke, coma and even it
might cause death to both mother and baby

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

- High blood pressure

- Protein in urine
- Head ache
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. © Wolters Kluwer Health.

 - Blurred vision
- Sudden weight gain

PCC What should the priority teaching for Olivia Jones include?

- Teaching Olivia do not take medication without doctor recommendation

- Suggesting her to have good diet, low salt intake

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

Situation- Oliva Jones is a 23-Year-Old female, African American who came to the
emergency department with mild preeclampsia.
Background: Oliva Jones is at 36-week gestation, G1P0, she didn’t know her pregnancy
until today. BP was 146/92 mm Hg
Assessment: BP upon assessment 154/95, HR 85. Deep tendon reflexes +2, Protein
dipstick +2. She was nauseated but denies head ache, epigastric pain, weight gain of 8
lb since last 2 week
Recommendation: low dose aspirin or antihypertensives beta blocker is recommended.,
monitor Blood pressure periodically

PCC What communication techniques could be initiated to decrease the anxiety of Olivia
Jones and her mother?

- calm and support Olivia

- preeclampsia during pregnancy is being very common and it will be handled if
Olivia follows medical advice from her provider and follows good eating habit.

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

- monitor her blood pressure & vital sign

- need to monitor Fetal heart rate continuously

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

I Consider what information on preeclampsia should be provided to Olivia Jones.

Priority teaching for Olivia Jones should include her plan of care and prognosis of the

disease. She should be given rationale for magnesium sulfate administration and
informed of the possibility for induced labor or c section.

Concluding Questions
Reflecting on Olivia Jones’s case, were there any actions you would do differently? Explain.

- I would have assessed vital sign at the beginning before taking verbal assessment
because those vital signs value are important during on critical situations.

Describe how you would apply the knowledge and skills that you obtained in Olivia Jones’s case
to an actual patient care situation.

- Olivia being virtual patient provided the great idea of caring real patient. I would care
real patient as same I did for Olivia, I would use same communicating technique,
privacy, assessment, intervention and would use same form of SBAR. I always will
make patient safety the main priority,

Maternity Case 1: Olivia Jones (Core)

Documentation Assignments

1. Document your initial assessment of Ms. Jones, including blood pressure, as well as your
assessment of the fetus.

Vital signs

Blood pressure- 154/95

Respiration- 12

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

.Heart rate- 85

Sp02- 97%

Temperature- 37

Deep tendon reflexes- +2

Protein dipstick +2

uterus contractions- none

fetal heart rate: 130/min

2. Write the situation-background-assessment-recommendation (SBAR) communication

you would use to update the provider on Ms. Jones’s status after your assessment of the
patient.

Situation- Oliva Jones is a 23-Year-Old female, African American who came to the
emergency department with mild preeclampsia.
Background: Oliva Jones is at 36-week gestation, G1P0, she didn’t know her pregnancy
until today. BP was 146/92 mm Hg
Assessment: BP upon assessment 154/95, HR 85. Deep tendon reflexes +2, Protein
dipstick +2. She was nauseated but denies head ache, epigastric pain, weight gain of 8
lb since last 2 week
Recommendation: low dose aspirin or antihypertensives beta blocker is recommended.,
monitor Blood pressure periodically
3. Document the nursing interventions carried out during this simulation, including the time
for each intervention, and evaluate the effectiveness of these measures in resolving the
problem.
- I put emesis basin, incase she feels like throwing
- I checked for blood, lochia & some discharge in bed
- I requested ultrasound examination to see fetus condition
- I took blood sample to check comprehensive metabolic and hepatic function.

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

4. Document the patient education that you provided to Ms. Jones.

I provided education about patient medical condition & ways to improve her health conditions.

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