Teen Pregnancy Case Study 3 RS presents for her 28 week visit. As her nurse you will walk her through her appointment and help to select appropriate care. Click start to begin. Characters: RS 28 weeks pregnant RS with the nurse talking to her to complete her history. Can be something like the picture above. A nurse using a Fetal Monitor on RS’s stomach. RS getting ready to leave and the nursing giving her the follow-up orders. START

Patient History A full history An updated history You bring RS back to gather her history. Select the type of history you will need to complete. A full history An updated history No history, patient was just seen 4 weeks ago No history is needed, you only need to collect a history at the beginning of the pregnancy. Programming Notes: Picture of a nurse gathering RS’s history. Allow the user to select one of the choices above. Depending on their answer a pop-up with the text below should appear. A full history (That is incorrect, try again.) An updated history (That is correct! Click “next” to continue.) No history, patient was just seen 4 weeks ago (That is incorrect, try again.) No history is needed, you only need to collect a history at the beginning of the pregnancy. (That is incorrect, try again.) NEXT

Options of Assessment Height Weight Heart Sounds Breath Sounds Click on the following assessment options to complete while getting the patient ready for her appointment. Some options provide information and some are not needed for the assessment. When you are finished, click NEXT to continue. Height Weight Heart Sounds Breath Sounds Blood Pressure Urine Dip Programming Notes: The user should be allowed to click on each item and a pop-up should come up with the following information. Height (Not needed) Weight (Starting weight, 115 lbs. Current weight 128 lbs. Total weight gain 13 lbs.) Heart Sounds (Not needed) Breath Sounds (Not needed) Blood Pressure (98/60) Urine Dip (Protein negative, Glucose Negative.) NEXT

Options of Assessment Weight- Total weight gain 13 lbs. Now that you have received the following assessment results for RS, click the drop down list to select whether they are normal or abnormal. Click Submit when you are finished. Weight- Total weight gain 13 lbs. Blood Pressure- 98/60 Urine Dip- Protein negative, Glucose negative Programming Notes: The user should be allowed to select either Normal or Abnormal from a drop down list and then click submit. Weight -Total weight gain 13 lbs. (Normal) Blood Pressure-98/60 (Normal) Urine Dip-Protein negative, Glucose Negative (Normal) SUBMIT

Options of Assessment Your Score = X out 3 All of the assessments for RS are normal. Click NEXT to continue. Programming Notes: Please allow the user to see their score as shown above. NEXT

Fetal Heart Rate Enter Number of beats_____________ You now have RS back in the room. Click her stomach to hear the fetal heart rate and count the beats. Enter the number of beats below. Click Submit. Enter Number of beats_____________ SUBMIT Programming Notes: You can have a picture just like the one above where the nurse is using a Fetal Heart Rate Monitor to listen to the baby’s heart rate. (Donna will provide a sound clip) Allow the students to enter the number of beats and submit. The correct number of beats is 140. If the student enters the correct number a pop-up should occur that says “That is correct! Click NEXT to continue.” If the student enters a different number a pop-up should occur that says “That is incorrect! The correct number of beats is 140. Click NEXT to continue.” Sound Clip for FHR The sound clip is the best quality I could find but it is too short – is there a way to have it repeat it over 40 seconds or so? So that students can count the beats. http://www.brooksidepress.org/Products/OBGYN_101/MyDocuments4/Sounds/28_week_fetal_heart.wav NEXT

Fetal Heart Rate The fetal heart rate is 140 bpm. Is this normal? YES Programming Notes: You can have a picture just like the one above. Allow the user to select Yes or No. The correct answer is yes. If the user clicks Yes have a pop-up that states “That is correct! A fetal heart rate of 140 bpm is normal. Click NEXT to continue.” If the user clicks NO– have a pop-up that states “That is incorrect. A fetal heart rate of 104 bpm is normal. Click NEXT to continue.” NEXT

Fundal Height How where would you measure the fundal height? Pubic symphysis to umbilicus Pubic symphysis to fundus Fundus to umbilicus Ischial process to fundus The fundal height for RS is 28cm is this normal or abnormal? Normal Abnormal The correct answer for 1 is B. Incorrect answers can say “That is incorrect. The correct answer is B.” The correct answer should just say “That is correct!” The correct answer for 2 is A. The incorrect answer can say “That is incorrect. The correct answer is A.” The correct answer should just say “That is correct”.  NEXT

Glucose Tolerance Test Non-stress Test RS has just finished seeing the provider and is ready to leave. She asks if there is anything else she needs to do today and when she will return. Select the correct “orders” for RS and then click NEXT to continue. OB visit in 1 week OB visit in 2 weeks OB visit in 4 weeks Routine Ultrasound Glucose Tolerance Test Non-stress Test Programming Notes: Picture of a nurse giving RS her orders for her next appointment. Create checkboxes next to each of the orders above. Allow the user to select the correct orders. Next

The correct orders for RS are shown below. RS will return in 2 weeks. OB visit in 1 week OB visit in 2 weeks OB visit in 4 weeks Routine Ultrasound Glucose Tolerance Test Non-stress Test Programming Notes: Highlight or somehow show the correct orders. The correct orders are #2 and #5. The activity ends here. Can show the same picture of RS receiving her orders. END