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Difficulty: MediumCollaboration with Interdisciplinary Team

A client who recently underwent a total laryngectomy and permanent tracheostomy placement is preparing to return home. The client will require continuous enteral feedings and expresses significant anxiety about managing the new airway independently. Which collaborative actions should the nurse include in the interprofessional discharge plan? Select all that apply.

  1. Coordinate with a speech-language pathologist to teach alternative communication strategies.Answer
  2. Arrange for a respiratory therapist to instruct the family on proper suctioning and humidification techniques.Answer
  3. Consult a social worker to assist in arranging home medical supplies and addressing emotional support needs.Answer
  4. D
    Assign the unlicensed assistive personnel to provide the client with written stoma care instructions.
  5. E
    Request a physical therapist to evaluate the client for gross motor deficits and gait instability.
  6. F
    Advise the family to reassure the client that feelings of anxiety are unwarranted and will quickly pass.

Answer

The nurse should coordinate with a speech-language pathologist, arrange for a respiratory therapist, and consult a social worker.
A client with a total laryngectomy requires a speech-language pathologist to learn alternative communication methods. The permanent tracheostomy requires specialized airway care education, making a respiratory therapist essential. Because the client expresses anxiety and needs home medical supplies, a social worker is crucial for coordinating resources and providing psychosocial support.

Step-by-Step Solution

1
Analyze the client's clinical presentation and physiological changes.
The client has a permanent tracheostomy (airway alteration) and a total laryngectomy (loss of vocal cords), leading to complex home care and communication needs.
Identifying the specific anatomical and functional changes dictates which interprofessional team members are required.
2
Identify the appropriate disciplines for the client's identified needs.
A speech-language pathologist is needed for communication, a respiratory therapist for airway care, and a social worker for psychosocial support and resource coordination.
Matching client deficits with specialized team members ensures safe and comprehensive discharge planning.
3
Evaluate the remaining options for inappropriate actions.
Delegating education to an unlicensed assistive personnel, prioritizing physical therapy without a mobility indication, and using non-therapeutic false reassurance are incorrect and unsafe actions.
Recognizing scope of practice boundaries and therapeutic communication principles is essential for safe nursing practice.

Key Concept

Effective interprofessional collaboration requires the nurse to accurately identify client needs and refer to appropriate specialists (e.g., respiratory therapy, speech-language pathology, social work) while adhering to safe delegation and therapeutic communication standards.
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Collaboration with Interdisciplinary Team

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