Guided Reflection Questions
Opening Questions
How did the simulated experience of Jackson Weber’s case make you feel? I felt a little
intimidated, this being my first pediatric VSIM. I was anxious, because I was not s
...
Guided Reflection Questions
Opening Questions
How did the simulated experience of Jackson Weber’s case make you feel? I felt a little
intimidated, this being my first pediatric VSIM. I was anxious, because I was not sure
what to expect.
Describe the actions you felt went well in this scenario. I felt after reading the physician
orders, I knew the main things I needed to focus on. This helped to give me some
reassurance.
Scenario Analysis Questions[*]
EBP List in order of priority your initial nursing actions identified for Jackson Weber
based on physical findings and family interaction. This patient had been brought to
the hospital because he had a seizure. His priority problem was seizure
management.
EBP What complications might Jackson Weber face if his symptoms are not
recognized and treated in a timely manner? The patient may experience a number of
complications if safety precautions are not followed. One of the biggest concerns
is patient injury. The patient needs to have side rails padded, all loose items
removed from bed and placed in a side lying position. Complications may be
abrasions or lacerations from the side rails. The patient may hit against the hard
metal or plastic and fracture or even break bones. If treatment is not implemented
after the seizure, the patient may experience decreased oxygen saturation, which
could compromise his neurologic status.
PCC What communication techniques should be initiated to decrease anxiety in
Jackson Weber’s mother while simultaneously caring for him? Educating the family of
a seizure patient is very important. Some of the important concepts to teach this
mother would be management of seizures. Topic might include: antiepileptic
medications, safety precautions, and extended family education. It is also
important to teach what to do during a seizure. Education might include:
maintaining airway patency, ensuring safety including the use of seizure pads,
avoiding risk of aspiration by removing loose objects near by and administering
medications.
PCC/S What seizure precautions should be taken by the nurse in anticipation of and at
the onset of Jackson Weber’s seizure? How might such precautions vary from hospital to
hospital? The nurse needs to watch for signs and symptoms such as; loss of
consciousness, jerking movements, loss of bowel and bladder control, and altered
breathing patterns. The patient should wear a medical alert bracelet, wear a helmet
and protective knee and elbow padding when doing anything extreme and take
medications as directed by his physician. Precautions may vary slightly from
hospital to hospital, but for the most part the basic goals are the same which is
patient safety.
S/QI Reflect on ways to improve safety and quality of care based on your experience
with Jackson Weber’s case. If the nurse can educate both the patient and the family
members on how to effectively manage seizures, a number of positive things may
happen. Response time will be quicker, safety measures achieved more rapidly,
and hopefully there will be a reduction in the adverse effects of the seizure. The
more knowledge we can instill in our patients and their family, the more we can
reduce their anxiety. Managing a crisis in a calm and efficient way will hopefully
help to ensure a more positive outcome for everyone.
T&C/I What key elements would you include in the handoff report for this patient?
Consider the situation-background-assessment-recommendation (SBAR) format. My
SBAR report would include the following: patient name, age, admission date and
reason for admission. I would report a brief history that the patient was diagnosed
with tonic-clonic seizures two year ago. Mom is a single parent who works, so
patient was last seen by Dr. approximately 15 months ago. I would report my
assessment of patient and include specifically neurologic, respiratory and cardiac
details. I would report any pertinent lab, diagnostic or pending test information. I
would then report the plan of care set in motion by the physician and my
recommendations for continued patient safety and comfort.
QI List additional support and health care team members to include to improve the
quality of care and to prevent reoccurrence of seizure activity and future hospitalizations
for Jackson Weber. The patient himself needs to be empowered to take an
important role on his seizure team. A patient who is five can be taught to let an
adult know if he feels something that is different, strange or out of the ordinary.
The patient’s mother is a crucial member of the team. She needs to focus by
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