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Maternity Case 3: Brenda Patton (Core)

Guided Reflection Questions

Opening Questions
How did the simulated experience of Brenda Patton’s case make you feel?

I felt okay for this simulation. The first time, I did not know where to click to calm the patient down
when she complained about hurting and feeling of contraction. I also did the vagina exam which is
contraindicated for her at that moment. I did better on the second round. I learned how to take care of
the young patient who having the first pregnant and have GBS positive. The case reminded me about
treatment for GBS which is 5 million unit of Penicillin initially and 2.5 million every 4 hours for patient.

Describe the actions you felt went well in this scenario.

I felt fairly confident throughout this simulation. The patient was manageable, and she was experiencing
only minimal discomfort. I educated and calmed her out through the simulation in regard to treat GBS,
how it will not affected the newborn.

Scenario Analysis Questions1

EBP What complications can occur if group B streptococcus is not treated?

GBS if left untreated during labor will cause sepsis, pneumonia, and meningitis in the newborn.

PCC What should be included in the priority teaching for Brenda Patton?

The priority teaching for this patient would be the rationale for giving IV Penicillin to treat GBS.
What GBS is and the complications that can occur, highlighting how GBS can affect the newborn

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

S: She stated that she felt her water may be broken earlier this morning and she think she is in
labor. Vaginal exam was reveals 50% effacement of cervix, 4 cm dilated, and fetus at -2 station.
Contractions are about 4 minutes apart, lasting for 50 seconds. Her lab results taken at 36 weeks
showed her GSB positive. Patient reported pain at 2 on the 0-10 scale between contractions,

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:

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

refuses pain medication. She felt nauseated and refuses emesis medication. Penicillin IVPB
admin via PIV as ordered.

B: Brenda Patton is an 18-year-old Caucasian female, G1P0 at 38 2/7 weeks of gestation. She
was admitted for labor assessment. GBS positive. Amnisure positive.

A: Vital signs are HR 86, BP 119/71, RR 19, T 37C, SpO2 100%. Respirations even and lung sound
clear. EFM: FHR 140. 02 applied via NRB.

Palpated the uterus for contractions. The uterus tone was soft between contractions. Regular
contractions with moderate intensity had started. Contraction were approximately 4 minutes
apart and lasting 50 secs. Small of the clear discharge observed upon examination. N

No edema to bilateral lower extremities. The deep tendon reflexes were normal.

Penicillin 5 million units administered as ordered, pt tolerated well. No signs of adverse


R: Continue to monitor pt as labor progress. Offer support and encouragement. Continue to

educate patient and family about outcome of the treatment and instill confidence within her
throughout the birthing process.

S/QI Based on your experience with Brenda Patton’s case, reflect on possible nursing actions for
enhanced safety and quality improvement.

In this case, more nonpharmacological interventions should have been implemented to help
reduce her pain and discomfort during contractions and also improve her progress laboring.
Educate regarding breathing exercises or distraction methods should have been implemented.
The patient would have been benefits from attending prenatal classes with a partner for better
preparation for a natural birth.

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

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

If it were a real case at the hospital, I would have more communication with the patient to better meet
their needs. This helps to accommodate all of the patient’s wishes and needs during the labor and
birthing process. This is Ms. Patton’s first experience with labor and delivery there will be many things
she does not know, and this can make her feel anxious. Continue support and encouragement is also
vital in a successful birth.

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

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