Pediatric Case 10: Charlie Snow (Complex) Guided Reflection Questions

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

Pediatric Case 10: Charlie Snow (Complex)

Guided Reflection Questions

Opening Questions How did the simulated experience of Charlie Snow’s case make you feel?This simulation was a bit stressful because dealing with emergency which affect vital signs, particularly airways and respiration require quick action and effective clinical reasoning for management, therefore I had to be ready for any emergency situation.Discuss the actions you felt went well in this scenario.I was able to obtain the objective and subjective data required to formulate my nursing diagnostic and care plan. This included the information provided by the caregiver and Charlie himself, as well have obtain vital sign to make sure I provided an accurate SBAR report to the provider in order to start treatment for Charlie as soon as possible before something happen.Scenario Analysis Questions * EBP List in order of priority your initial nursing actions identified for Charlie Snow based on physical findings and family interaction.Raise the bed from semi fowler to fowler to increase lung capacity. Assess Charlie Vital signs, mental status and auscultation of his lung.EBP What complications might Charlie Snow face if symptoms are not recognized and treated in a timely manner?A complication of anaphylactic reaction with serious consequence such as drop in blood pressure and even death can arise if no action is taken in a timely manner.EBP Why was a glucocorticosteroid administered in this case? Would it have been appropriate to administer albuterol in this case? Why or why not?Glucocorticosteroid helps to decrease or minimize the reaction and prevent the return of symptoms, specially the inflammatory response. No albuterol should be used because this can increase the anaphylaxis risk and cause further breathing problems. Instead Albuterol can only be use after the use of epinephrine injection because there are short acting bronchodilator

* 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/

Pediatric Case 10 Charlie Snow (Complex) Guided Reflection Questions

From vSim for Nursing | Pediatric. © Wolters Kluwer Health.PCC What communication techniques could be initiated to decrease the anxiety of Charlie Snow’s aunt?It is important to use therapeutic communication with Charlie Snow’s aunt. This include asking open ended questions, listening to her in silence, giving recognition, explaining the procedure and care plan in term which facilitates her comprehension.S/QI Reflect on ways to improve safety and quality of care based on your experience with Charlie Snow’s case.Safety includes the 5 rights for medication administration, assessing the vital sign correctly, correct identification of the patient, maintaining hand hygiene, proper and correct SBAR report with other healthcare team, and continue monitoring and reassessment of the patient.S/I Because Charlie Snow is accompanied by his aunt and not by a parent, what legal matter must be considered before performing treatment?She will need to provide and sign a consent form which granted authority from the parent to ask as their liaison when seeking medical treatment for Charlie.T&C What role do you feel Charlie Snow’s guardians and parents have as members of his health care team? (Explain your answer.) Charlie’s guardians and parents are important in providing safety at home through what is provided to him as food (to prevent allergy) and how they educate him in making responsible choices even at his gage. They play a crucial role a member of his health care team. they will be his first line of defense to improve his quality of health. They will need to monitor, assess, provide comfort, assist with medication and treatment in case of another occurrence of symptoms, and will be the advocate and voice for the child; therefore it is indispensable to have their opinion during this recovery process and educate them properly on his medical condition.

T&C/I What key elements would you include in the handoff report for this patient? Consider the situation-background-assessment-recommendation (SBAR) format.Situation: 6 years old boy with anaphylaxis reaction. Currently on 2L nasal canula, saline lock on left arm, able to talk through dyspnea.Background: Brought in by caregiver for accidental ingestion of cookie containing peanut which he is allergic for. Family is not present, and Aunt is the authorized legal gradient at the moment.Assessment: Sinus tachycardia HR 156 bpm, pulse is present, BP 109/73 mmHg, RR 30, Alert & oriented X 3, SPO2 at 91%, Temp 37.2 C. Per provider order, he was started on 420 ml bolus over 30 Mn of

Pediatric Case 10 Charlie Snow (Complex) Guided Reflection Questions

From vSim for Nursing | Pediatric. © Wolters Kluwer Health.Normal Saline, 0.3 mg epi 1:10000 iv, 25 mg diphenhydramine IV, 20mg ranitidine IV, and 10mng methylprednisolone IV.Recommendation: Keep patient on fowler position, continue monitoring for vital sign, evaluation of post medication administration. Contact provider for if no improvement is noticed.Concluding Questions Reflecting on Charlie Snow’s case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently?My assessment and intervention in Charlie’s case were appropriate in my opinion. One action I would have added will be asking his opinion or any questions he may have during this process and how best to facilitate the care delivery experience within the goals set. I should have also reassess his breathing post medication assessment to make sure of improvement.

Describe how you would apply the knowledge and skills that you obtained in Charlie Snow’s case to an actual patient care situation.Caring for a patient in anaphylaxis requires a lot of knowledge, attention to detail and skills; especially when there are medical complications involved. I have learned that it is important to evaluate, and clinically process any situations that arise so to have a broad views and facilitate the caring process.Continuous monitoring and reassessment of the patient is crucial during these moment and also the proper way to communicate and educate both the patient and caregiver can also facilitate intervention process.