Maternity Case 9: Fatime Sanogo (Core)

Guided Reflection Questions

Opening Questions
How did the simulated experience of Fatime Sanogo’s case make you feel?

I was so nervous a first when I did this simulation because that was the first time I took care for
postpartum hemorrhage. Other than that, it went pretty well. I have found as long as I follow the
doctor’s order and make sure the order make sense to provide care for the patient. I thought the
language barrier would be more an issue, but it didn’t really seem to be evident in the scenario.

Describe the actions you felt went well in this scenario.

I think that my assessments were done well and follow the doctor’s order.

Scenario Analysis Questions1

EBP What risk factors did you identify in Fatime Sanogo’s case related to postpartum hemorrhage?

Risk factors included the fact that Fatime was 41 4/7 weeks pregnancy and was delivery very
close to post-term. The delivery was induced by oxytocin and had a prolonged second stage. The
baby was large, at 9 lbs, and she had second degree perineal laceration during delivery. The
infant was also born within the last 24 hours.

EBP List in order of priority your initial nursing actions based on your assessment of Fatime Sanogo
and her family.

Based on my assessment of Fatime my nursing actions in order of priority are:

- Assessment of blood, color, amount, odor, & consistency of lochia: weight the peripads to
determine amount
- Assessment of the uterus: consistency, position, & placement
- If uterus is boggy immediately perform fundal massage to try and get the uterus to contract:
notify provider if fundus does not respond to massage
- Follow providers order and administer the ordered uterotonic drug.

1
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 | Maternity. © Wolters Kluwer Health.

EBP List potential problems for Fatime Sanogo if her symptoms are not recognized in a timely
manner.

If symptoms are not recognized Fatime could continue to hemorrhage and go into hypovolemic
shock, DIC, die.

PCC What communication techniques could be initiated to decrease the anxiety of Fatime Sanogo
and her husband and provide care that is culturally sensitive?

To decrease Fatime’s anxiety, the use of a translator would be extremely beneficial to provide
accurate information and ease the tension of not understanding because the language barrier
between her and the nurse. The use of translator will help Fatime feel more secure in knowing
what is going on.

Concluding Questions
Reflecting on Fatime Sanogo’s case, were there any actions you would do differently? Explain.

Describe how you would apply the knowledge and skills that you obtained in Fatime Sanogo’s case to an
actual patient care situation.

I would most definitely do a lot of things differently. I would want as much help as I can when get in the
room. I know that it is important to get bladder emptied since bladder displacement is the most
common cause of uterine atony. Once the bladder has been emptied, then I would continue to assess
the fundus and if uterine atony is still present and the fundus is boggy a fundal massage would be the
next step. If that does not help, phoning the provider and administering the ordered uterotonic med
would be implanted. I learned that it is extremely important to continuously assess the fundus and
monitor for the effectiveness of the interventions being implemented.

From vSim for Nursing | Maternity. © Wolters Kluwer Health.