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Difficulty: MediumCollaboration with Interdisciplinary Team

An older adult client is hospitalized for severe dehydration, malnutrition, and a newly developed sacral pressure injury. The client's spouse, who is the sole caregiver at home, appears exhausted and states, "I am physically unable to turn my spouse in bed anymore, and they refuse to eat any meals I prepare." Which of the following is the most appropriate nursing action to support this client's transition of care?

  1. A
    Instruct the unlicensed assistive personnel to perform a comprehensive dietary assessment.
  2. B
    Ask the spouse, "Why did you wait so long to seek medical attention for these issues?"
  3. Facilitate referrals to a medical social worker and a clinical dietitian.Answer
  4. D
    Reassure the spouse that a complete loss of appetite is a normal, expected part of getting older.

Answer

Facilitate referrals to a medical social worker and a clinical dietitian.
The correct answer addresses both the physical and psychosocial deficits present in the scenario. The spouse is demonstrating significant caregiver role strain and physical limitations, which requires the expertise of a medical social worker to arrange home health assistance, respite care, or proper medical equipment. Furthermore, the client's refusal to eat and subsequent malnutrition require a clinical dietitian to develop a targeted nutritional intervention plan. Effective interprofessional collaboration ensures a safe and comprehensive transition of care.

Step-by-Step Solution

1
Analyze the clinical scenario and identify the primary needs.
The client has complex physiological deficits (malnutrition, pressure injury) and psychosocial barriers (an exhausted caregiver lacking the physical ability to provide safe home care).
Accurately identifying all barriers to a safe discharge is the first step in care coordination.
2
Determine the scope of practice for various interdisciplinary team members.
A clinical dietitian is the expert required for treating malnutrition, and a medical social worker is the expert for addressing caregiver role strain and securing community resources.
Nurses must recognize when a client's needs exceed standard nursing interventions and require specialized allied health professionals.
3
Evaluate the distractors for safety, delegation, and communication principles.
The other options violate core nursing principles: inappropriate delegation to a UAP, using nontherapeutic communication, and confusing a pathological state with normal aging.
Eliminating actions that are unsafe or outside the scope of practice confirms the correct collaborative approach.

Key Concept

Collaboration with Interdisciplinary Team
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Topics

Collaboration with Interdisciplinary Team

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