Maternity Case 1: Olivia Jones (Core)

Guided Reflection Questions

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

I feel okay about this vSim since her s/s weren’t severe, but still was on edge worried she could take turn
for the worst

Describe the actions you felt went well in this scenario.

Everything went well. I did dim the light and keep her calm, and made sure I got a head to toe as well as
focused assessment for s/s of preeclampsia. I wanted to thoroughly check her legs for edema, and I
wanted to get a look at how the baby was doing on the monitor.

Scenario Analysis Questions1

EBP What are the risk factors for Olivia Jones and her baby if preeclampsia is not treated in a timely
manner?

She could progress to eclampsia in which she’s experiencing seizures, HELLP syndrome, and
eventually maternal and fetal demise

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

Headache, edema, nausea, epigastric pain, dizzy, sudden weight gain (r/t the edema and fluid
imbalance), blurry vision/vision changes.

PCC What should the priority teaching for Olivia Jones include?

Best rest/limit stimuli are important to keep Olivia’s Bp down. It’s also important to teach her
about the pathophysiology of this disorder and that the only cure is birth.

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

S: 23 y/o African American female, G1P0 at 36 weeks gestation present to L&D with nausea,
fatigue and edema and 8lb weight gain over 2 weeks.

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.

 B: uneventful pregnancy up until today’s prenatal appointment. This is patient’s 1 st pregnancy
and baby is active with baseline FHR of 130 bpm.

A: Her BP was 146/92 mm Hg, DVT is normal at +2, UA was negative for ketones, +2 for protein,
negative for glucose. HEENT was unremarkable, RR of 18 with cleat and equal lung sounds. Skin
turgor and integrity WNL, wild edema noted of the hand and legs. Normal reactive bowel
sounds. No contraction felt on palpation and bag of water is intact. Pt is on bed rest orders and
seizure padding is up. Instructed to use call light for assistance.

R: continue to monitor I&O’s, vitals, and maintain seizure precautions. Monitor FHR and
contractions for preterm labor.

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

Educate patient and answering all questions with honesty, reassurance. Encourage to use call
light for any concerns or questions.

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

Because there’s risk her condition can develop to eclampsia, Olivia’s bed has been fitted with
seizure pads, she’s on bed rest with restricted mobility, and should be instructed to use call light
if she need anything. Keeping the lights dim and keeping the noise down will also help keep her
comfortable and her blood pressure from going to high.

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

General patient education on the pathophysiology of the disorder along with how to monitor
her urine output, her blood pressure (when she’s discharged) and fetal movement. Educate her
on the s/s of her condition worsening (headache that does not go away, epigastric pain, blurry
vision, etc) and when to call the provider. Also teaching her about staying hydrated, and off her
feet. As scary as it might be, she also needs to be informed that should her condition worsen,
she may need to deliver as that is the only “cure” for this condition.

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

I would have performed the assessment with the lights dimmed, just to provide a little more comfort

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

I think the skill I’ve learned in this module would be very helpful in treating future pt. I would definitely
do my best to keep the pt calm, lights dim, and encourage rest.

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

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