Reference no: EM133295613

Report from the Pediatric Unit shift nurse:

Situation: Jackson Weber is a 5-year-old male. He was brought to the emergency department (ED) last night by his parent after experiencing 4 seizures at home within a 12-hour period.

Background: Jackson was diagnosed with generalized tonic-clonic seizures 2 years ago. Upon diagnosis, Jackson's neurologist started him on oral phenobarbital. Jackson has been seizure-free until last night, when he was brought to the ED. He had one seizure in the ED, and it required the administration of lorazepam. He also received a loading dose of phenobarbital in the ED because his blood levels were low. All other blood work was normal. He has been prescribed phenobarbital twice a day. He has an IV in his left arm with an infusion of 5% dextrose in 0.9% sodium chloride running at 58 mL/hr. His parent is single and the sole source of financial support. The parent lost their job 3 months ago and has not been able to afford his medications.

Assessment: Jackson's vital signs have been stable. His pupils are equal and reactive to light. He is able to move all extremities equally. He is awake and alert and is watching cartoons. His parent is at the bedside. He has experienced no seizure activity overnight.

Recommendation: Please continue to monitor for any seizure activity. His parent seems a bit sad, so make sure the parent is okay and can manage Jackson's illness when going home. Consider conversation with the parent regarding social support.

opening Questions

How did the simulated experience of Jackson Weber's case make you feel?

Describe the actions you felt went well in this scenario.

Scenario Analysis Questions*

EBP/S What priority problem did you identify for Jackson Weber?

EBP What complications might Jackson Weber face if safety precautions are not taken during the seizure activity and if treatment is not implemented after the seizure?

PCC What should the nurse teach Jackson Weber's regarding the ongoing care of his condition?

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?

PCC/S Describe strategies to empower Jackson Weber and his caregiver in the management of his seizures.

T&C List potential team members in Jackson Weber's care. (Explain your answer.)

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

Concluding Questions

Reflecting on Jackson Weber's case, were there any actions you would do differently? If so, what were these actions, and why would you do them differently?

Describe how you would apply the knowledge and skills you obtained in Jackson Weber's case to an actual patient care situation.