A nurse is coordinating the discharge plan for a 78-year-old client recovering from a recent right-hemisphere cerebrovascular accident. During breakfast, the nurse observes the client consistently ignoring food on the left side of the tray, clearing their throat repeatedly after drinking water, and struggling to grasp utensils to cut food. The client's spouse states, "I suppose I will just have to feed them pureed food from now on since they are getting clumsier with age." Which collaborative intervention is the most appropriate priority for the nurse to initiate?
- Consult Occupational Therapy to address the visual field deficit and fine motor challenges, and Speech-Language Pathology to evaluate the swallowing mechanics.Answer
- BConsult Physical Therapy to address the upper extremity weakness and request a Registered Dietitian to automatically transition the client to a mechanical soft diet with thickened liquids.
- CDelegate all mealtime assistance to the Unlicensed Assistive Personnel during the remainder of the admission and refer the spouse to a medical social worker for home care planning.
- DDocument the spouse's willingness to provide care, attribute the uncoordinated movements to expected age-related decline, and arrange for a home health aide to assist with daily living.
Answer
The nurse must consult Occupational Therapy for the fine motor and visual neglect issues, and Speech-Language Pathology for the potential dysphagia.
The correct selection accurately targets Occupational Therapy to manage the fine motor skills required for grasping utensils and the compensatory strategies needed for left-sided unilateral neglect. Additionally, it appropriately targets Speech-Language Pathology as the essential discipline to evaluate the throat clearing, which is a key clinical indicator of dysphagia and aspiration risk.
Step-by-Step Solution
Key Concept
Interdisciplinary Collaboration: Scope of Practice