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Difficulty: HardCollaboration with Interdisciplinary Team

A pediatric rehabilitation nurse is developing a multidisciplinary discharge plan for a 5-year-old client who recently sustained a severe traumatic brain injury. The client has a newly placed tracheostomy, receives continuous enteral tube feedings, exhibits spastic hemiplegia affecting mobility, and demonstrates significant developmental regression. The client's parents are highly anxious and express feeling overwhelmed regarding how they will afford home medical equipment and manage the child's complex physical needs. Which of the following collaborative actions should the nurse include in the plan of care? Select all that apply.

  1. Consult a physical therapist to establish safe transfer techniques and a gross motor mobility plan to address the spastic hemiplegia.Answer
  2. B
    Delegate the initial observation and evaluation of the parents' ability to perform tracheostomy suctioning to the unit's unlicensed assistive personnel (UAP).
  3. Refer the family to a medical social worker to assist with identifying funding for medical equipment and navigating community financial support programs.Answer
  4. D
    Collaborate with a child life specialist to provide the 5-year-old with detailed written pamphlets and anatomical diagrams to explain the long-term prognosis of the brain injury.
  5. Request a speech-language pathologist to evaluate the client's swallowing function and determine the safety of eventual oral intake.Answer
  6. F
    Cancel the referral for a psychiatric liaison, assuming the family's traditional cultural background dictates that they will only accept emotional support from their local religious leaders.

Answer

The correct collaborative actions include consulting a physical therapist to address mobility and transfers, referring the family to a medical social worker for financial assistance and resource navigation, and requesting a speech-language pathologist to evaluate swallowing function for future oral intake.
Optimal care for a complex pediatric client requires coordinated interdisciplinary collaboration. A physical therapist is required to address gross motor deficits such as spastic hemiplegia and establish safe mobility techniques. A speech-language pathologist is the appropriate professional to evaluate swallowing and the safety of progressing from enteral to oral feedings. A medical social worker is essential for assessing the family's psychosocial coping and connecting them with financial resources for necessary medical equipment.

Step-by-Step Solution

1
Identify the client's complex physiological, developmental, and psychosocial needs presented in the clinical vignette.
Identified needs include gross motor deficits (hemiplegia), swallowing evaluation for transition from enteral feeding, high parental anxiety, and lack of financial resources for equipment.
Deconstructing the scenario is required to determine which interdisciplinary specialties and nursing actions are indicated.
2
Match the identified clinical needs with the correct interdisciplinary team member's scope of practice.
Physical therapy matches mobility/hemiplegia. Speech-language pathology matches swallowing/oral intake progression. Social work matches financial/community resource navigation.
Effective collaboration relies on accurate referrals to the appropriate allied health professionals.
3
Evaluate the remaining options against safety principles, delegation rules, and culturally competent care standards.
Delegating initial skill evaluation to a UAP is unsafe. Providing abstract diagrams to a 5-year-old is developmentally inappropriate. Canceling a referral based on a cultural stereotype is a failure of individualized assessment.
Distractors in complex care scenarios often blend incorrect scopes of practice with unsafe nursing judgments.
4
Select the evidence-based actions that reflect proper interprofessional collaboration and safe nursing practice.
The appropriate referrals are for the physical therapist, medical social worker, and speech-language pathologist.
These choices reflect a comprehensive, safe, and accurate multidisciplinary discharge plan.

Key Concept

Interdisciplinary Collaboration, Delegation, and Scope of Practice in Complex Pediatric Care
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Topics

Collaboration with Interdisciplinary Team

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