Pediatric Case 10: Charlie Snow (Complex)
Guided Reflection Questions
Opening Questions
How did the simulated experience of Charlie Snow’s case make you feel?
During the simulation I felt worried because I knew that he was going to have trouble breathing.
Discuss the actions you felt went well in this scenario.
I felt that whenever he started having trouble breathing and his oxygen was falling that I did well with
placing the non rebreather on him and calling the provider.
Scenario Analysis Questions*
EBP
List in order of priority your initial nursing actions identified for Charlie Snow based on physical
findings and family interaction.
Airway related to anaphylaxis, breathing and circulation of the patient. The highest priority is
ineffective airway clearance.
EBP
What complications might Charlie Snow face if symptoms are not recognized and treated in a
timely manner?
Anaphylaxis is a potentially life threatening situation, it must treated immediately because it can
fatal. Your blood pressure decreases and your airways narrow which blocks breathing.
EBP
Why was a glucocorticosteroid administered in this case? Would it have been appropriate to
administer albuterol in this case? Why or why not?
Albuterol does not help with inflammation it only dilates to help with breathing.
PCC
What communication techniques could be initiated to decrease the anxiety of Charlie Snow’s
aunt?
Therapeutic communication should be used to decrease anxiety and allowing family to be
included in patient care.
*
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 10
Charlie Snow (Complex)
Guided Reflection Questions
S/QI
Reflect on ways to improve safety and quality of care based on your experience with Charlie
Snow’s case.
Following the rights of medications administration is a very important safety precaution
especially when you are giving drugs such as epinephrine.
S/I
Because Charlie Snow is accompanied by his aunt and not by a parent, what legal matter must
be considered before performing treatment?
Written legal consent is required before any treatment can be provided.
T&C
What role do you feel Charlie Snow’s guardians and parents have as members of his health care
team? (Explain your answer.)
Him and his family need to be educated on how to give an injection when needed and what
should be done if that type of situation arises. Also the family needed to be educated on how to
watch for foods that may be a problem. This will help manage and prevent future problems.
T&C/I What key elements would you include in the handoff report for this patient? Consider the
situation-background-assessment-recommendation (SBAR) format.
Patient is a 6 year old who was brough to the hospital for difficulty breathing after consuming
food that contained peanuts. He is alert and oriented. I assess the iv access which is dry and
intact. The patient states he is feeling better after his anaphylaxis reaction, vitals are stabilizing.
Education was provided to patient and relative. Monitor vitals until discharge, monitor airway
and breathing patterns.
From vSim for Nursing | Pediatric. © Wolters Kluwer Health.
Pediatric Case 10
Charlie Snow (Complex)
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?
I would contact the provider sooner and administer the STAT medication that was ordered
Describe how you would apply the knowledge and skills that you obtained in Charlie Snow’s case to an
actual patient care situation.
I went through the simulation with the instructor and my clinical group so it was nice to have input
during this. In a real life scenario things would have went very differently when the patient went into
anaphylaxis.
From vSim for Nursing | Pediatric. © Wolters Kluwer Health.