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Difficulty: EasyCollaboration with Interdisciplinary Team

An older adult client is recovering on the medical-surgical unit following an ischemic stroke. The nurse observes the client coughing frequently and pocketing food in their cheek during breakfast. Which action should the nurse take to provide safe, collaborative care?

  1. Request a referral to a speech-language pathologist for a swallowing evaluation.Answer
  2. B
    Instruct the unlicensed assistive personnel (UAP) to feed the client very slowly.
  3. C
    Prioritize teaching the client's family how to prepare a pureed diet for discharge.
  4. D
    Reassure the client that difficulty eating is an expected and temporary phase of recovery.

Answer

Request a referral to a speech-language pathologist for a swallowing evaluation.
The client is exhibiting clear signs of dysphagia, which places them at a high risk for aspiration pneumonia. The speech-language pathologist (SLP) is the specific interdisciplinary team member trained to perform a comprehensive swallowing assessment and recommend safe dietary modifications (such as thickened liquids or pureed foods). Collaborating with the SLP is the safest and most appropriate intervention.

Step-by-Step Solution

1
Analyze the client's symptoms during the meal.
Coughing and pocketing food are classic signs of dysphagia (difficulty swallowing) and indicate a high risk for aspiration.
Identifying acute physical changes is the first step in the nursing process to ensure client safety.
2
Identify the appropriate interdisciplinary team member to address this specific deficit.
The speech-language pathologist (SLP) is identified as the expert in swallowing mechanics.
Effective interprofessional collaboration requires knowing the scope of practice of various allied health professionals.
3
Initiate the collaboration.
The nurse requests an SLP referral and holds oral intake until the client is formally evaluated.
Prompt referral prevents aspiration pneumonia and ensures a safe dietary plan is established.

Key Concept

Speech-Language Pathologists (SLPs) are the primary interdisciplinary team members responsible for evaluating and managing dysphagia (swallowing difficulties) to prevent aspiration.
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Topics

Collaboration with Interdisciplinary Team

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