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Difficulty: HardCollaboration with Interdisciplinary Team

A registered nurse is caring for a client who recently underwent an open reduction internal fixation (ORIF) of a left femoral shaft fracture. The nurse observes the client developing acute dyspnea, tachypnea, and a petechial rash on the anterior chest. The nurse initiates an emergency call to the rapid response physician. Arrange the following statements in the correct sequence according to the SBAR (Situation, Background, Assessment, Recommendation) interprofessional communication tool.

  1. 1State, 'I am calling regarding the client in room 412 who is experiencing a sudden onset of severe shortness of breath and agitation.'
  2. 2Provide context, stating, 'The client is 36 hours post-operative following an open reduction internal fixation of a left femoral shaft fracture.'
  3. 3Report current findings: 'The oxygen saturation is 84% on room air, respiratory rate is 34 breaths per minute, and a new petechial rash is present on the upper chest.'
  4. 4Request action: 'I need a provider at the bedside immediately to evaluate for a potential fat embolism and write orders for supplemental oxygen and arterial blood gases.'

Answer

The correct sequence follows the standard SBAR protocol: identifying the immediate crisis (Situation), providing the surgical context (Background), sharing objective clinical data (Assessment), and requesting specific collaborative interventions (Recommendation).
The SBAR communication tool is the gold standard for interprofessional collaboration and handoffs in acute care. The sequence must logically proceed from establishing the immediate crisis (Situation), to explaining the patient's history (Background), presenting the latest clinical data (Assessment), and finally proposing the required intervention (Recommendation).

Step-by-Step Solution

1
Identify the 'Situation' statement.
Select the statement describing the sudden onset of shortness of breath and agitation.
The first step in SBAR is to immediately state the core problem so the interdisciplinary team member understands the urgency of the call.
2
Identify the 'Background' statement.
Select the statement detailing the 36-hour post-operative status from a femur fracture.
Once the problem is stated, the provider needs brief, pertinent historical context to understand how the patient arrived at this state.
3
Identify the 'Assessment' statement.
Select the statement providing the vital signs (84% SpO2, 34 respirations) and the physical finding of a petechial rash.
The nurse must provide the current objective and subjective data supporting the concern before asking for orders.
4
Identify the 'Recommendation' statement.
Select the statement requesting a bedside evaluation, oxygen, and ABG orders.
The final step in SBAR requires the nurse to advocate for the client by clearly outlining the requested interventions from the physician.

Key Concept

Interprofessional SBAR Communication Protocol
Estimated Time:1m 0s
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Topics

Collaboration with Interdisciplinary Team

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