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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is participating in an interdisciplinary care conference for a client with metastatic bone cancer who is transitioning to home hospice care. The client reports severe, escalating pain despite the current analgesic regimen, struggles with feeding and dressing due to profound weakness, and the client's spouse expresses feeling overwhelmed by the financial burden of purchasing home medical supplies. Which of the following collaborative actions are appropriate? (Select all that apply.)

  1. Request a palliative care or pain management consultation to re-evaluate and optimize the current analgesic regimen.Answer
  2. Request a medical social worker evaluation to assist the family in identifying community financial resources for medical equipment.Answer
  3. Initiate an occupational therapy referral to assess the client's ability to perform activities of daily living and suggest adaptive aids.Answer
  4. D
    Assign the unlicensed assistive personnel (UAP) to evaluate the family's home for potential safety hazards prior to discharge.
  5. E
    Offer reassurance to the spouse by stating that financial burdens are a normal part of the process and will resolve soon.

Answer

The appropriate collaborative actions include requesting a palliative care consultation for complex pain management, consulting a medical social worker to assist with financial resources, and initiating an occupational therapy referral for support with activities of daily living.
The correct actions appropriately utilize the interdisciplinary team to address complex client needs. A palliative care provider specializes in managing severe pain in terminal illnesses. A medical social worker is the expert in connecting families with financial assistance and community resources. An occupational therapist specializes in evaluating and improving a client's ability to perform activities of daily living (ADLs) through adaptive equipment and techniques.

Step-by-Step Solution

1
Identify the primary clinical and psychosocial needs presented in the scenario.
The client requires advanced pain management, financial assistance for home supplies, and support for impaired activities of daily living (ADLs).
Accurate identification of patient and family needs determines which interdisciplinary team members must be involved.
2
Match the identified needs with the appropriate interdisciplinary team members' scope of practice.
Palliative care addresses the escalating pain, a medical social worker addresses the financial distress, and occupational therapy addresses the ADL deficits (feeding and dressing).
Effective interprofessional collaboration requires referring specific issues to the specialized experts trained to handle them.
3
Evaluate the remaining actions for delegation principles and therapeutic communication.
Delegating the home safety assessment to a UAP is an improper delegation of assessment, and telling the spouse that finances will 'resolve soon' constitutes false reassurance.
Nurses must retain tasks requiring assessment or clinical judgment and must maintain therapeutic communication by acknowledging and exploring client concerns.

Key Concept

Interdisciplinary team collaboration involves matching specific client needs (such as complex pain, financial distress, and ADL deficits) with the appropriate specialized team members while adhering to safe delegation principles and therapeutic communication.
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Collaboration with Interdisciplinary Team

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