Ashley Ramirez
Josephine Morrow
Guided Reflection Questions
Opening Questions
How did the simulated experience of Josephine Morrow’s case make you feel?
It made me feel pretty good. I liked being able to look back at what I have learned at school and see if I
could apply it correctly. It was difficult trying to figure out how to word and where to put things in docu
care, which stressed me out a little bit.
Talk about what went well in the scenario.
I feel as if my wound care and health assessment went very well. I was able to get the information
needed to educate the patient and to take care of their wound properly.
Reflecting on Josephine Morrow’s case, were there any actions you would do differently if you were to
repeat this scenario? If so, how would your patient care change?
I would probably ask more questions. I feel as if I could have missed out on some important information
if I didn’t ask more about their lifestyle or what might have happened for the wound to get to that point.
I would see why the patient wasn’t eating as much as well or why they were not eating protein.
Scenario Analysis Questions
S What priority problem(s) did you identify for Josephine Morrow?
chronic venous insufficiency, venous stasis ulcer, high risk for infection, and complications related to
immobility.
PCC Identify in Josephine Morrow’s health history any factors that predisposed her to having chronic
venous insufficiency.
Obesity and COPD
PCC/S Discuss the assessment findings and diagnostic studies that correlate with chronic venous
insufficiency and venous stasis ulceration.Relate the pathophysiology to these assessment
findings.
Josephine was found to have developed a venous stasis ulcer on her right medial malleolus. She had 2+
edema with bilateral brown hyperpigmentation in the lower extremities. Her lab results of low
albumin and prealbumin support these findings. The protein difcenicy would make the healing
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 | Fundamentals. © Wolters Kluwer.
Ashley Ramirez
process more slow, along with her being sedentary lifestyle causing lack of circulation. Wound
assessment for color, size, location, temperature, drainage and odor support the findings of the
ulcer. These findings support her diagnosis of chronic venous insufficiency and venous stasis
ulceration.
S What is the rationale for the daily dose of ASA?
Patient has a history of DVT and ASA can act as a blood thinner to prevent clots.
EBP/I What is the rationale for compression therapy?
It promotes venous return. With chronic venous insufficiency the valves of the veins do not function
very well causing venous flow issues.
EBP/I What is the rationale for performing a Braden scale assessment on Josephine Morrow?
She has risk factors that can lead to a pressure ulcer. She has impaired mobility, malnutrition, chronic
conditions, older in age, and is obese.
T&C What other interprofessional team members should be involved in Josephine Morrow’s care?
Physical therapy, dietician, Health care provider, and possibly a wound specialist.
Concluding Questions
Describe how you would apply the knowledge and skills that you acquired in Josephine Morrow’s case
to an actual patient care situation.
It taught me to look at a patients past history and how it can correlate with what is currently going on.
How important it is to see why a medication is being taken, the importance of documenting and
assessing a wound. I would make sure to look at lab results to see if they correlate with their symptoms
and being able to teach the patient how to improve their problem with education. I will make sure to do
a thorough assessment and intake on my future patients.
From vSim for Nursing | Fundamentals. © Wolters Kluwer.
