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Difficulty: HardCollaboration with Interdisciplinary Team

A nurse is managing the care of a client with a severe exacerbation of myasthenia gravis. The client is experiencing new-onset choking when drinking liquids, profound upper extremity weakness preventing self-feeding, and significant anxiety regarding the financial burden of a potential long-term care placement. Which interdisciplinary actions should the nurse include in the client's plan of care? Select all that apply.

  1. Initiate an urgent referral to a speech-language pathologist (SLP) to evaluate the client's swallowing and aspiration risk.Answer
  2. Request a consultation with a social worker to assist the family with long-term care planning and financial resources.Answer
  3. Collaborate with an occupational therapist (OT) to assess the client's ability to perform activities of daily living and recommend adaptive equipment.Answer
  4. D
    Delegate the initial oral feeding and swallowing observation to an unlicensed assistive personnel (UAP) to ensure adequate nutritional intake.
  5. E
    Delay the speech-language pathology consultation to first hold a comprehensive interdisciplinary meeting about the client's financial concerns.
  6. F
    Alleviate the client's anxiety by providing a guarantee that the case manager will secure full financial coverage for the long-term care facility.

Answer

The correct actions include initiating an SLP referral for the swallowing evaluation, consulting a social worker for financial and placement planning, and collaborating with an OT for ADL assessment and adaptive equipment.
The correct referrals address the client's specific multidimensional needs within the appropriate scopes of practice. A speech-language pathologist specializes in evaluating and managing dysphagia and aspiration risk. A social worker or case manager is equipped to navigate healthcare financing and long-term care placements. An occupational therapist focuses on improving fine motor skills and providing adaptive devices to maximize independence in activities of daily living (ADLs).

Step-by-Step Solution

1
Analyze the client's multifaceted clinical presentation.
The client presents with a physiological airway/swallowing compromise (choking), a functional deficit (upper extremity weakness affecting self-feeding), and a psychosocial need (anxiety regarding finances and placement).
Identifying specific deficits is the first step in determining which interdisciplinary team members are required.
2
Match the identified clinical deficits to the appropriate interdisciplinary team members' scopes of practice.
Choking requires a Speech-Language Pathologist (SLP); upper extremity weakness and ADL impairment require an Occupational Therapist (OT); financial and placement anxiety requires a Social Worker.
Operating within each discipline's specialized scope of practice ensures safe, comprehensive, and effective care coordination.
3
Evaluate the remaining options based on safety, prioritization, and communication standards.
Delegating the feeding of an unstable client is unsafe; delaying an airway assessment for a financial meeting violates the ABCs; and guaranteeing financial outcomes constitutes false reassurance.
Safe nursing practice requires strict adherence to delegation rules, Maslow's hierarchy of needs, and therapeutic communication principles.

Key Concept

Interdisciplinary Collaboration, Prioritization, and Delegation
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Topics

Collaboration with Interdisciplinary Team

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