Pediatric Case 9: Charlie Snow (Core)

Guided Reflection Questions

Opening Questions
How did the simulated experience of Charlie Snow’s case make you feel?

The experience of Charlie Snow made me feel familiar because I am familiar with mild allergic reactions
or responses. I felt as though this was a good reminder that not every patient will have instant
improvement upon receiving medication.

Describe the actions you felt went well in this scenario.

I felt that everything went well in this scenario. This scenario actually allowed me to practice dealing
with pediatric patients that come into the emergency room with adults/relatives who are not their
parents.

Scenario Analysis Questions1

EBP What priority problem did you identify for Charlie Snow?

My priority nursing actions were to assess Charlie to make sure he was not in anaphylactic state.
He had urticaria on his chest and upper arms and suffered from severe itchiness and discomfort
and to assess his pain, if any, before I called the provider to get prescription to treat the
symptoms.

EBP What complications might Charlie Snow face if his allergy is not recognized and actions are not
initiated in a timely manner?

If symptoms are not recognized and treated in a timely manner, complications that Charlie could
face could be impaired skin integrity due to the itching of the urticaria of his skin which can lead
to sores and bleeding.

PCC What teaching measures should be included during Charlie Snow’s visit to the clinic?

Charlie and his caregiver should be aware to avoid wash towels, linens, and clothes that were
washes in fragranced detergent and other materials that flare up his allergies. Charlie is also
allergic to peanuts and should be taught how to administer an EpiPen in case of emergencies.

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 9
Charlie Snow (Core)
Guided Reflection Questions

PCC Describe the age-appropriate strategies to empower Charlie Snow in the management of his
allergies.

Charlie should be aware of the foods and other household items that may make him sick and
should be taught to avoid them. Teach Charlie to not accept food from people other than his
family that is aware of his allergies. Charlie should also know to look for an adult for help if he
even feels unwell.

S/I Discuss what measures Charlie Snow and his aunt should take if he has an allergic response.
How can you use age-appropriate informatics for assistance in teaching?

Charlie should be given another dose of diphenhydramine if he ever has another allergic
response. If Charlies ever exhibits SOB, wheezing, coughing, etc, he should be taken to an ER
because he might be having anaphylaxis.

S/I Because Charlie Snow is accompanied by his aunt and not by a parent, what legal matter must
be considered before performing treatment?

The legal matter that must considered before performing treatment is identifying legal consent

T&C Why is it important that Charlie Snow’s aunt communicate with Charlie’s teacher, school nurse,
and principal about his allergies? What should she communicate?

Charlies teacher, school nurse, and principal should be aware of his allergies so they can help
prevent any future allergic reactions, and if one occurs they would know what to do to help him.

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

Charlie Snow is 6 year old male who is staying with his aunt and uncle. Charlie’s aunt brought
him into the emergency department as he recently developed a red macular rash on his chest
and arms at Charlie reports is super itchy. During my assessment, I did not find anything
abnormal except his complaint of being super itchy. He was ordered 12.5 mg of
diphenhydramine PO. I give him first dose but patient is still reporting that he’s not feeling
better so they provider was informed and I handed off the patient.

QI Describe some actions that should take place to improve Charlie Snow’s quality of care.

One way that I would improve his care if by applying a topical cream to help soothe Charlie skin
so it wouldn’t be itchy and red. The diphenhydramine will help in the same way but I believe
doing this well help Charlie getting better and possibly have a better outcome.

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

 Pediatric Case 9
Charlie Snow (Core)
Guided Reflection Questions

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?

No, I would not have done any actions differently.

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

If this was an actual patient I would have applied the knowledge and skills that same way.

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