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Difficulty: HardCollaboration with Interdisciplinary Team

A client with metastatic pancreatic cancer is preparing for discharge to home hospice care. The client has severe cachexia, requires maximum assistance with bathing due to profound weakness, and expresses deep spiritual distress about the end of life. The client's spouse feels overwhelmed and states they cannot physically manage the demands of providing daily hygiene care. Which action by the nurse demonstrates the most appropriate interdisciplinary collaboration?

  1. A
    Delegating the development of a home hygiene schedule to the unlicensed assistive personnel (UAP) and requesting a psychiatric consult for the client's distress.
  2. Requesting a medical social worker to coordinate in-home hospice aide services and consulting a chaplain to provide spiritual support.Answer
  3. C
    Consulting a physical therapist to improve the client's transfer mobility and reassuring the spouse that physical care will become easier to manage over time.
  4. D
    Prioritizing a referral to a registered dietitian to reverse the client's cachexia before addressing the family's logistical home care concerns.

Answer

The most appropriate action is to request a medical social worker to coordinate in-home hospice aide services and consult a chaplain to provide spiritual support.
The correct response accurately delegates tasks within the scope of practice of the interdisciplinary team. A medical social worker specializes in navigating community resources and arranging logistical support, such as home hospice aides. A chaplain is trained to address existential and spiritual distress at the end of life without utilizing a psychiatric model, which is usually unnecessary unless there is an underlying severe mental health disorder.

Step-by-Step Solution

1
Analyze the client's specific deficits and needs.
The client has two primary needs: logistical/physical support for daily hygiene (due to spouse's inability to manage it) and emotional/existential support for end-of-life distress.
Accurate identification of needs dictates which interdisciplinary team members should be involved in the transition of care.
2
Identify the overarching goal of care for this client.
The client is transitioning to home hospice care, meaning the goal is palliative comfort, dignity, and family support, rather than curative or rehabilitative interventions.
Understanding the care phase prevents inappropriate referrals, such as restorative physical therapy or aggressive nutritional reversal.
3
Match the identified needs to the correct allied health scopes of practice.
A medical social worker is the correct professional to navigate healthcare systems and coordinate community resources like in-home aides. A chaplain is the expert in managing existential and spiritual distress.
Collaborating with the correct team members ensures safe, effective, and holistic discharge planning.

Key Concept

Interdisciplinary collaboration in palliative care requires appropriately utilizing medical social workers for resource coordination and chaplains for spiritual distress, while avoiding curative interventions and improper delegation.
Estimated Time:1m 30s
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Collaboration with Interdisciplinary Team

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