Pediatric Case 3: Sabina Vasquez (Core)

Guided Reflection Questions

Opening Questions
How did the simulated experience of Sabina Vasquez’s case make you feel?

I felt very confident in the case that I needed to provide in regard to her asthma diagnosis. I knew what
assessment were needed and how to take care of respiratory issue.

Describe the actions you felt went well in this scenario.

I feel confident about my ability to assess Sabina included vital signs, head to toes assessments as well
as focus assessment on her respiratory issue, and also some questions related to her condition. Then I
called the doctor for order.

Scenario Analysis Questions1

EBP What priority problem did you identify for Sabina Vasquez?

Altered respiratory statues due to asthma causing inflammation in her respiratory system where
she presented with wheezing.

EBP What complications might Sabina Vasquez face if her symptoms are not recognized and treated
in a timely manner?

Respiratory distress leading to possibly ARDS which will put her at risk for alter tissue perfusion,
altered LOC.

PCC Describe the barriers that Sabina Vasquez and her family may encounter that would hinder
active participation in Sabina’s care.

The language barrier is the biggest thing that Sabina Vasquez and her family would encourage
and hinder participation in care because she may not be able to understand their care.

PCC What should be done to overcome the language barrier between the health care team and
Sabina’s mother?

Get an approved language interpreter for communication

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 | Pediatric. © Wolters Kluwer Health.

 Pediatric Case 3
Sabina Vasquez (Core)
Guided Reflection Questions

PCC Describe age-appropriate strategies to empower Sabina Vasquez and her mother in all aspects
of the health care process.

Having Sabina perform a teach back of how to properly use her inhaler and have her mother do
the same. Explaining all the things that I am doing to Sabina so herself and mother can ask if
they have any questions

PCC What is your attitude toward Sabina Vasquez’s cultural background? How might your attitude
affect the care you provide to Sabina and her family?

Her culture values in regard to medical, food, etc, would need to be assessed in order to provide
the best patient care. A patient’s culture is very important to me and I always try to ensure I am
not offending family and patients.

PCC What teaching needs to be given to Sabina Vasquez and her mother on the management of her
asthma?

Sabina and her mother are needed to know how to use the inhaler in proper way, Sabina should
carry her rescue inhaler with her, and what triggers that cause an asthma attack they need to
avoid.

PCC Identify the possible triggers of Sabina Vasquez’s asthma exacerbation and assist the family in
developing a plan of action to mitigate these triggers.

Possible triggers include dust mites, molds, animal dander, and pollen. Her mother and family
should cleaning the floor daily with mop and closing of windows when pollen is abundant in the
air like in spring in order to help Sabina’s issue.

S/QI Reflect on ways to improve safety and quality of care based on your experience with Sabina
Vasquez’s case.

To improve safety and quality of care for Sabina, I would educate the pt and family reducing as
much as possible in the house, hard floors need to be mopped regularly to help avoid buildup of
dust and allergens, maybe try to reduce the number of pets in the house and the most
important thing is to educate about smoking, Sabina should avoid smoking areas.

T&C What role does Sabina Vasquez’s mother have as a member of her health care team? (Explain
your answer.)

She is definitely the coordinator of care. Since the patient is only five year old, her mother is
going to be the primary care giver, and also her biggest advocate.

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

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

 Pediatric Case 3
Sabina Vasquez (Core)
Guided Reflection Questions

S: The patient has history of asthma and she reported having trouble breathing. Some
assessments are performed for her at admission. I called the doctor and Sabina is given order of
albuterol in a nebulizer.

B: Sabina Vasquez is 5 yo Hispanic girl admitted to the clinic due to her history of asthma,
however, she is healthy. Her family moved here from Mexico two years ago.

A: Her vital signs include HR 130, RR 19, T 36.2, SpO2 95, BP 118/80. Capillary refill time was less
than 2 secs. The lung sound with audible wheezes. She stated that she has no pain by using
FACES scale. Her peak flow was showed 75L/min. She received 2.5 mg dose of albuterol in a
nebulizer and she tolerated well. Her peak flow was assessed again after medication and it was
85L/min.

R: Sabina’s mother doesn’t speak English well, so interpreter might be attended for
communication. Continuing on assessment and education for the pt and her family.

I Describe the importance of using an approved, trained interpreter rather than a family member
or ancillary staff member for data collection and teaching in Sabina Vasquez’s case.

The use of approved interpreter is best because they understand the medical language and will
interpret verbatim what the healthcare provide is saying. A family member may not know
medical term and leave the important word said by the healthcare provider.

Concluding Questions
Reflecting on Sabina Vasquez’s case, were there any actions you would do differently? If so, what were
these actions, and why would you do them differently?

I believe I did well in the scenario, the only things I was missing for the first simulation was I did not
show the FACES scale to the patient.

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

The scenario helped me in gaining confidence in the way I care for patient without any doctor’s order. I
know that I need to do head to toes assessment as well as focus assessment due to her condition. Then
call the doctor for the order.

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

 Pediatric Case 3
Sabina Vasquez (Core)
Guided Reflection Questions

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