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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is caring for a client admitted with an exacerbation of myasthenia gravis. During the morning assessment, the client reports increasing generalized muscle fatigue and new-onset difficulty swallowing (dysphagia) when eating breakfast. To promote safe and effective care, which of the following actions by the nurse represents the most appropriate interdisciplinary collaboration?

  1. A
    Consult the registered dietitian to conduct a bedside swallowing study and prescribe the appropriate liquid consistency.
  2. B
    Delegate the initial assessment of the client's gag reflex and ability to swallow to the unlicensed assistive personnel.
  3. Request a speech-language pathologist to conduct a comprehensive swallowing evaluation and recommend diet modifications.Answer
  4. D
    Reassure the client by stating, 'Everything will be fine once your medications work,' and delay consulting allied health services.

Answer

The nurse should request a speech-language pathologist to conduct a comprehensive swallowing evaluation and recommend diet modifications.
A speech-language pathologist (SLP) is specially trained to evaluate the mechanics of swallowing, perform diagnostic tests (such as a modified barium swallow study), and determine the safest diet consistency for clients experiencing dysphagia. Consulting an SLP directly addresses the client's mechanical deficit and prioritizes airway protection, which is essential for a client with myasthenia gravis experiencing muscle fatigue.

Step-by-Step Solution

1
Analyze the client's clinical presentation.
The client with myasthenia gravis has new-onset dysphagia (difficulty swallowing), which places them at a high risk for aspiration and airway compromise.
Identifying the primary physiological threat (airway and breathing) dictates the necessary interventions and team member referrals.
2
Determine the appropriate interdisciplinary team member for the specific deficit.
A speech-language pathologist (SLP) specializes in the mechanics of swallowing and speech.
Proper delegation and collaboration require matching the client's specific clinical need with the allied health professional's designated scope of practice.
3
Select the action that represents safe and effective collaboration.
Requesting an SLP consultation directly addresses the mechanical swallowing issue, whereas delegating to a UAP is unsafe, and dietitians do not evaluate mechanical swallowing safety.
This ensures the client receives specialized care to protect the airway while avoiding out-of-scope delegation.

Key Concept

Interdisciplinary Collaboration for Dysphagia
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Topics

Collaboration with Interdisciplinary Team

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