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Difficulty: HardCollaboration with Interdisciplinary Team

A 72-year-old client with advanced Parkinson's disease is admitted to a subacute rehabilitation unit following treatment for aspiration pneumonia. During the initial assessment, the nurse observes the client clearing their throat repeatedly after sipping water and experiencing a "freezing of gait" when attempting to stand. The client also struggles to manipulate the buttons on their hospital gown. The client's spouse tearfully states, "I do not know how we will afford the bathroom modifications needed for discharge." Which collaborative action should the nurse prioritize?

  1. Request a consultation with a speech-language pathologist to perform a comprehensive swallowing evaluation.Answer
  2. B
    Consult with a physical therapist to develop a mobility plan addressing the client's gait freezing.
  3. C
    Coordinate with an occupational therapist to assess fine motor skills and recommend adaptive clothing.
  4. D
    Instruct the unlicensed assistive personnel to feed the client all meals to ensure close observation.

Answer

Requesting a consultation with a speech-language pathologist to perform a comprehensive swallowing evaluation.
The client is exhibiting signs of active dysphagia (repeated throat clearing after sipping water) and has a recent history of aspiration pneumonia. According to Maslow's Hierarchy of Needs and the ABC (Airway, Breathing, Circulation) prioritization framework, protecting the client's airway is the absolute highest priority. Collaborating with a speech-language pathologist (SLP) for a comprehensive swallowing evaluation is essential to prevent recurrent aspiration, respiratory failure, and ensure immediate physiological safety.

Step-by-Step Solution

1
Analyze the client's clinical presentation and identify all abnormal assessment findings.
The client has recent treatment for aspiration pneumonia, clears their throat after sipping water (dysphagia risk), experiences gait freezing (fall risk), and struggles with fine motor tasks (ADL deficit).
Comprehensive assessment is required before prioritizing interventions.
2
Determine the appropriate interdisciplinary team member for each identified client need.
Dysphagia requires a Speech-Language Pathologist (SLP). Gait freezing requires a Physical Therapist (PT). Fine motor deficits require an Occupational Therapist (OT).
Collaborative care requires accurate matching of client needs to specialized allied health scopes of practice.
3
Apply Maslow's Hierarchy of Needs and the ABC (Airway, Breathing, Circulation) framework to prioritize the referrals.
Airway protection (swallowing/dysphagia) takes physiological precedence over mobility (gait) and functional independence (buttoning clothes).
Airway compromise is an immediate life-threatening risk, making the SLP referral the absolute highest priority.

Key Concept

Prioritization of Interdisciplinary Referrals based on Airway, Breathing, and Circulation (ABCs)
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Collaboration with Interdisciplinary Team

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