Eva Madison
Opening Questions
-How did the simulated experience of Eva Madison’s case make you feel?
I didn’t mind this scenario it was interesting to see the variations in a pediatric patient
versus an adult
patient.
-Describe the actions you felt went well in this scenario.
Initial assessment went well, so did administering her IV fluids. Communication with
both the patient and her mother went well too.
-EBP List in order of priority your initial nursing actions identified for Eva Madison based
on physical findings and family interaction.
My initial nursing actions were vital signs assessment and then administering IV fluids
as ordered, in hindsight I feel that I maybe should have reversed that order.
-EBP When initiating a fluid bolus for a dehydrated child, what type of fluid should be
given and why?
Normal saline would be administered first, until an assessment can be done you
wouldn’t want to give dextrose or anything else until we know what her fluid and
electrolytes are.
-EBP What complications might Eva Madison face if her symptoms are not recognized
and treated in a timely manner?
She may experience hypovolemic shock, she may be extremely dehydrated, her blood
pressure
would continually decrease, and circulatory collapse can occur.
-PCC What measures should be initiated to decrease anxiety in Eva Madison’s mother
while simultaneously caring for Eva?
Therapeutic communication, and constantly keeping her informed.
S/QI Reflect on ways to improve safety and quality of care based on your experience
with Eva Madison’s case.
Providing more oxygen supplementation and doing daily weights on the patient.
S/QI What infection control measures should be taken in this case and why?
She should be on contact precautions for possible CDIFF until the cause of her illness is
found.
T&C/I What key elements would you include in the handoff report for this patient?
Consider the situation-background-assessment-recommendation (SBAR) format.
Situation: Patient Eva Madison 5 years old, admitted to emergency room with diarrhea
and vomiting for 3 days, she has had no urine output for 12 hours,
Background: the patient is dehydrated with vomiting and diarrhea. Mother states no
previous medical problems.
Assessment: BP 88/70, T 99 F, SPO2 94%, RR 31, HR 176
Recommendation: Continue maintenance fluids and monitor dehydration signs and
symptoms for improvement.
Concluding Questions
-Reflecting on Eva Madison’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 not give the bolus even though patients s/s had not resolved which is why I did
not think it appropriate to start maintenance fluids.
-Describe how you would apply the knowledge and skills you obtained in Eva Madison’s
case to an actual patient care situation.
I will be able to use what I learned in this simulation to provide care for a pediatric case
potentially experiencing hypovolemic shock and will be able to recognize signs and
symptoms and how to treat it.