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Difficulty: MediumCollaboration with Interdisciplinary Team

An older adult client with Parkinson's disease is medically stable and ready for discharge following treatment for aspiration pneumonia. The client demonstrates persistent dysphagia, exhibits a recent 10% unintentional weight loss, and is experiencing sudden episodes of acute confusion. The client's spouse will provide all care at home. Which actions should be included in the collaborative discharge plan? Select all that apply.

  1. Involve a speech-language pathologist to assess swallowing safety and determine appropriate dietary textures.Answer
  2. Engage a registered dietitian to design a high-calorie nutritional regimen that accommodates the swallowing limitations.Answer
  3. Coordinate with a medical social worker to identify available community resources and caregiver support services.Answer
  4. D
    Assign the unlicensed assistive personnel to perform a comprehensive safety assessment of the client's home layout.
  5. E
    Teach the spouse that abrupt cognitive changes and confusion are typical age-related cognitive declines.
  6. F
    Provide reassurance to the client by promising a complete restoration of their previous physical function and weight.

Answer

The appropriate actions are involving a speech-language pathologist for swallowing assessment, engaging a registered dietitian for nutritional planning, and coordinating with a medical social worker for caregiver support.
A speech-language pathologist is essential to evaluate the client's dysphagia and prevent further aspiration. A registered dietitian is necessary to address the 10% weight loss by formulating a high-calorie diet tailored to the client's swallowing abilities. A medical social worker is vital to support the spouse by arranging community resources, home health, and respite care.

Step-by-Step Solution

1
Analyze the client's specific clinical presentation and care needs.
The client has dysphagia, significant weight loss, acute confusion, and a spouse requiring support.
Identifying specific deficits dictates which interdisciplinary team members are required for a safe discharge.
2
Match the identified needs with the correct interdisciplinary team members' scope of practice.
Dysphagia requires a speech-language pathologist; weight loss requires a registered dietitian; caregiver burden requires a medical social worker.
Effective collaboration relies on utilizing specialized team members for specific client issues.
3
Evaluate the remaining options against core nursing principles.
Delegating assessments to UAP, dismissing sudden confusion as normal aging, and providing false reassurance are all incorrect nursing actions.
Ensuring safe delegation, recognizing pathology, and maintaining therapeutic communication are fundamental RN responsibilities.

Key Concept

Interdisciplinary collaboration involves utilizing specialized team members to address specific client deficits while maintaining appropriate RN responsibilities for assessment, safety, and therapeutic communication.
Estimated Time:1m 30s
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Collaboration with Interdisciplinary Team

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