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Difficulty: MediumCollaboration with Interdisciplinary Team

An orthopedic unit nurse is initiating a telephone call to the on-call physician regarding a post-surgical client experiencing sudden respiratory distress. Place the nurse's intended statements in the correct sequence following the SBAR interprofessional communication framework.

  1. 1"This is the nurse on the orthopedic unit calling about the client in room 410 who is experiencing sudden, sharp chest pain and severe dyspnea."
  2. 2"The client is 2 days postoperative following a right total hip arthroplasty and has a known history of deep vein thrombosis."
  3. 3"The client is diaphoretic, with a heart rate of 122 beats/min, a respiratory rate of 30 breaths/min, and an oxygen saturation of 88% on room air."
  4. 4"I need you to evaluate the client immediately and request an order to initiate supplemental oxygen and a STAT CT pulmonary angiogram."

Answer

The correct sequence strictly follows the SBAR format: Situation, Background, Assessment, and Recommendation.
The SBAR framework is an evidence-based communication tool designed to standardize interprofessional handoffs and urgent provider notifications. It follows a logical flow: stating the immediate problem (Situation), providing the clinical context (Background), sharing the current clinical data (Assessment), and asking for specific, targeted actions (Recommendation).

Step-by-Step Solution

1
Identify the 'Situation' statement.
The statement introducing the nurse, the specific unit, and the client's acute presentation of sudden chest pain and dyspnea.
The SBAR protocol requires immediately establishing who is calling and the primary acute reason for the communication.
2
Identify the 'Background' statement.
The statement outlining that the client is 2 days post-op with a known history of deep vein thrombosis.
Once the problem is stated, the provider needs the clinical context, surgical history, and relevant risk factors to understand the patient's baseline.
3
Identify the 'Assessment' statement.
The statement providing the current abnormal vital signs (heart rate 122, respiratory rate 30, oxygen 88%) and physical findings like diaphoresis.
Objective clinical data and the nurse's evaluation of the current problem must be presented to support the severity of the situation.
4
Identify the 'Recommendation' statement.
The statement requesting an immediate bedside evaluation, supplemental oxygen, and a STAT CT angiogram.
The communication must conclude with a clear, actionable request to the provider to ensure immediate patient safety.

Key Concept

SBAR (Situation, Background, Assessment, Recommendation) Interprofessional Communication
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Collaboration with Interdisciplinary Team

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