Brenda Patton Guided Reflection Questions

Maternity Case 4: Brenda Patton (Complex)
Guided Reflection Questions
Opening Questions
How did the simulated experience of Brenda Patton’s case make you feel?
- It always makes me feel a little overwhelmed going through the scenario the first time, because I
am always nervous and almost expecting something to go wrong. After going through the
scenario one time though it becomes much simpler, and I am able to fall back on assessments
and make sure that I go through a systemic approach.
Describe the actions you felt went well in this scenario.
- I felt that going through the assessment I did a good job of finding information and then
adjusting to what I needed to do next. I felt that I am improving on checking in with the Dr. and
not getting stuck if I am unsure of what to do next. I thought that I did a good job assessing both
the mom and the baby.
Scenario Analysis Questions1

EBP Based on the initial assessment of Brenda Patton, what findings did you find concerning?
- In the initial assessment Brenda Patton status was satisfactory. I did not find anything of concern
during my assessment, but her vitals were all within normal range with a heart rate of 90, blood
pressure was 120 / 72, respirations were 20 and temperature was 37 degrees Celsius, with a O2
saturation of 98%, and pain registering on the numerical pain scale of a 2 out of 10. The fetal
heart rate was 151 with occasional accelerations. Her headed to assessment did not show any
abnormalities. Her GBS results came back positive, and I found that fact concerning. This could
possibly lead to her newborn acquiring complications such as sepsis, pneumonia, or meningitis,
if not treated as soon as possible
PCC Brenda Patton stated that she would like to labor free of medication. What are some techniques
that could be used to help her with her pain?
- there are many nonpharmacological techniques that we could use to help her with pain. Several
of those techniques include movie around in different positions and getting up and walking
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.

around the room, using a pregnancy ball to sit on, listening to music therapy or imagery could
help relax this patient, practicing breathing techniques, effleurage and therapeutic touches.
T&C What key elements would you include in the handoff report for this patient? Consider the
situation-background-assessment-recommendation (SBAR) format.
- Patient is a 17-year-old who is G1P0, water broke 18 hours ago, amended with contractions that
were four minutes apart and lasting 50 seconds. Amniotic fluid was clear upon inspection period
vital signs within normal ranges, patient rates pain as a 2 of 10. Fetal heart rate is 151 beats per
minute with occasional accelerations. FM were placed on the patients right lower quadrant of
abdomen. GBS results are positive in antibiotics were ordered. Patient was educated about
antibiotic therapy necessary. Administered 5,000,000 units of penicillin IVPB, continue to
administer in a biotic per providers orders, provide support especially through contractions.
Patient requires a natural birth, assist her and nonpharmacological pain management. Assess
Q1h
S/QI Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for
enhanced safety and quality improvement.
- For this patient education would be helpful so that the patient was aware of some of the
techniques to use for pain management. Prior education about ways to reduce the chances of
premature labor would have been useful as well. Interventions such as keeping the perineum
area as clean as possible, should have been initiated, especially after rupture of the membranes,
in order to decrease the chances of bacteria entering and causing unwanted complications.
Involving the support from the parents would have been helpful to deal with pain management
in this situation also.
Concluding Questions
Reflecting on Brenda Patton’s case, were there any actions you would do differently? Explain.
- I ordered labs and performed examinations that weren’t necessary because I was not
experienced enough with the scenario. I need to make sure that I am carefully reviewing the
MAR so that I can see what the plan of care has been before me and so that I am better direct
an appropriate plan of care moving forward. In these scenarios I am sometimes drawing labs
and doing assessments that are not only not necessary but also harmful in some situations. I
performed a vaginal exam on this patient because I thought it was necessary but instead, I put
this patient at risk for an infection because of my poor understanding of how to properly handle
this situation.
Describe how you would apply the knowledge and skills that you obtained in Brenda Patton’s case to an
actual patient care situation.

- The knowledge from the scenario will make me better prepared for when I actually get to see a
real-life patient, but I think with a real patient I will need to remember to have more empathy
and understanding of how this patient is feeling and what I can do to assist her with more social
and emotional needs. The scenario portrays a life situation, but it is hard to feel any sort of
connection or realness with a cartoon on a laptop.

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Maternity Case 4: Brenda Patton (Complex)

Guided Reflection Questions

Describe the actions you felt went well in this scenario.

Scenario Analysis Questions1

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

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

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

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