Amelia Sung Core Guided Reflection (1)

MATERNITY CASE 5: AMELIA SUNG (CORE) This study source was downloaded by 1000 F 0 r 0 o 82 m883 v 7 S 6 i 6 m2 f f r o om r NCo u u r rs s e i H n e g ro | .cMom a o t n e 0 r 8 n -1 it 3 y - . 20©21W07: o 3 l 8 t : e 18 rs G KM l T uw-05 e : r 00 Health. Maternity Case 5: Amelia Sung (Core) Guided Reflection Questions Opening Questions How did the simulated experience of Amelia Sung’s case make you feel? At first, I was nervous because I didn’t know what to do first, But I made sure I went over the orders well and then I just did what needed to be done. Describe the actions you felt went well in this scenario. I feel I was a bit slow, but I got everything I needed to get for the delivery, I made sure the patient stayed calm, and made sure all her vital signs were stable. Scenario AnalysisQuestions1 EBP/I Discuss why shoulder dystocia is an obstetrical emergency. It’s an obstetrical emergency because physicians may cause injuries such as brachial plexus palsy, broken bones, and facial injuries. Depending on if an injury occurs after shoulder dystocia, the symptoms may include nerve damage and pain in the injured area, a claw-like hand appearance, light paralysis of the affected limb. Mothers are also at risk for medical complications if shoulder dystocia occurs, such as hemorrhaging, uterine rupture, and lacerations. EBP Name one of the two distinct signs that indicate shoulder dystocia is present. One distinct signs of shoulder dystocia is the “turtle sign”, which involves the appearance and retraction of the fetal head (analogous to a turtle withdrawing into its shell), and another sign is the erythematous, puffy face indicative of facial flushing. This occurs when the baby's shoulder is obstructed by the maternal pelvis. EBP List potential problems for Amelia Sung and her baby related to the shoulder dystocia. She is already prone for it because she has a history of it. So, the potential problems are that it could happen again, and if it does the baby can have nerve damage and pain in the injured area, a claw-like hand appearance, or light paralysis of the affected limb. Mothers are also at risk for medical complications, such as hemorrhaging, uterine rupture, and lacerations. PCC/T&C What preventive measures were put in place related to Amelia Sung’s history of a previous shoulder dystocia? 1The 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: This study source was downloaded by 1000 F 0 r 0 o 82 m883 v 7 S 6 i 6 m2 f f r o om r NCo u u r rs s e i H n e g ro | .cMom a o t n e 0 r 8 n -1 it 3 y - . 20©21W07: o 3 l 8 t : e 18 rs G KM l T uw-05 e : r 00 Health. The NICU team was ready for the baby, the nurse and OB dr., were ready and there for the mother and baby for the whole delivery time. S/QI/I Consider what points might be included in a safety checklist for shoulder dystocia. The unit can use an established approach to managing and documenting episodes of shoulder dystocia. This approach can include the care provider clearly stating the concern for shoulder dystocia, communication to othersfor assistance to put a plan for safe delivery into place, role designation of staff (e.g. recorder, patient/family communicator), clinical maneuvers and directed maternal pushing, recording time of dystocia identification, and time of maneuvers as performed, and documentation of episodes and elements. Concluding Questions Reflecting on Amelia Sung’s case, were there any actions you would do differently? Explain. The first attempt I made at this vsim I was not prepared at all for the actual birth. I forgot to get the bassinette and delivery table ready. To improve I would focus on being prepared for the birth and not forgetting any key elements. Describe how you would apply the knowledge and skills that you obtained in Amelia Sung’s case to an actual patient care situation. I feel like if I were to sit in for an actual birth now I would be a lot more prepared because of this simulation. This gave me a good idea of what a vaginal delivery is like.