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Difficulty: HardCollaboration with Interdisciplinary Team

A client is preparing for discharge following a 4-week hospitalization for severe Guillain-Barré syndrome. While the client's respiratory function is now stable, they exhibit significant residual weakness in their intrinsic hand muscles, preventing them from grasping eating utensils or manipulating buttons on clothing. The client's spouse expresses feeling overwhelmed about managing these daily care tasks at home and states, 'I do not know how we will afford all the special tools the doctor said we might need.' Which interdisciplinary collaboration action by the nurse is the most appropriate?

  1. A
    Consult the speech-language pathologist to assess for silent aspiration risk during meals and request the registered dietitian perform a calorie count.
  2. B
    Refer to physical therapy to evaluate fine motor grip strength and assign the unit's unlicensed assistive personnel to demonstrate feeding techniques to the spouse.
  3. Consult the occupational therapist to train the spouse in adaptive self-care techniques and the medical social worker to identify community financial resources.Answer
  4. D
    Inform the spouse that insurance usually covers these expenses eventually and consult the physical therapist to initiate upper extremity strengthening exercises.

Answer

The correct action is to consult the occupational therapist to train the spouse in adaptive self-care techniques and the medical social worker to identify community financial resources.
The correct answer accurately identifies the distinct scopes of practice required for this client's specific deficits. The occupational therapist (OT) specializes in fine motor skills, upper extremity function, and adapting activities of daily living (ADLs) such as eating and dressing. The medical social worker (MSW) is the appropriate team member to evaluate financial constraints, coordinate community resources, and assist with acquiring affordable medical equipment.

Step-by-Step Solution

1
Analyze the client's clinical presentation.
The client has fine motor deficits preventing them from grasping utensils or buttoning clothes, and the caregiver has severe financial anxieties regarding medical equipment.
Identifying specific needs dictates which interdisciplinary team members should be consulted.
2
Match the clinical deficits to the appropriate allied health scopes of practice.
Fine motor skills and activities of daily living (ADL) adaptations fall within the scope of occupational therapy, not physical therapy.
Proper interprofessional collaboration requires accurate knowledge of each team member's expertise.
3
Address the psychosocial and financial concerns.
The medical social worker is the optimal referral for navigating insurance, finances, and community assistance programs.
Holistic care requires addressing both physical and psychosocial barriers to a safe discharge.
4
Evaluate the distractor actions for safety and communication errors.
Delegating teaching to a UAP is unsafe and outside their scope, and offering unverified financial promises is non-therapeutic false reassurance.
Safe and effective care environments mandate appropriate delegation and therapeutic communication.

Key Concept

Interdisciplinary collaboration requires the registered nurse to accurately identify client needs and match them to the distinct scopes of practice of allied health professionals, while maintaining safe delegation and therapeutic communication boundaries.
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Collaboration with Interdisciplinary Team

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