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Difficulty: HardCollaboration with Interdisciplinary Team

A nurse in a neurological rehabilitation unit is caring for a client recovering from a severe exacerbation of multiple sclerosis. The client has developed new-onset bilateral intention tremors and profound fatigue. During morning care, the client is unable to grip a toothbrush, repeatedly drops eating utensils, and becomes tearful about the inability to perform prescribed intermittent self-catheterization. Which collaborative action is most appropriate for the nurse to implement?

  1. Request a referral to an occupational therapist to evaluate for adaptive devices and fine motor strategies.Answer
  2. B
    Delegate the client's feeding, hygiene, and catheterization tasks to the unlicensed assistive personnel to conserve energy.
  3. C
    Consult a physical therapist to prioritize lower extremity strength and ambulation training over the localized upper extremity deficits.
  4. D
    Reassure the client that the tremors are temporary and avoid discussing the loss of independence to prevent further emotional distress.

Answer

Request a referral to an occupational therapist to evaluate for adaptive devices and fine motor strategies.
An occupational therapist specializes in helping clients achieve independence in activities of daily living (ADLs) through the rehabilitation of fine motor skills and the provision of adaptive equipment. In this scenario, the occupational therapist can provide weighted utensils to dampen the intention tremors and teach specialized strategies or provide adaptive tools to allow the client to successfully perform intermittent self-catheterization.

Step-by-Step Solution

1
Analyze the client's specific clinical deficits and current setting.
The client is in rehabilitation and experiencing fine motor deficits (intention tremors) that prevent them from completing basic activities of daily living (brushing teeth, eating, self-catheterization).
Identifying the specific type of functional limitation is required to determine the correct interdisciplinary team member to consult.
2
Differentiate the roles of interdisciplinary team members.
Occupational therapists focus on fine motor skills and ADLs, while physical therapists focus on gross motor skills and mobility.
Correct referral depends on matching the client's specific need (fine motor/ADL adaptation) with the appropriate professional scope of practice.
3
Evaluate the distractors against safe nursing practice principles.
Delegating to assistive personnel violates delegation rules for teaching/assessment, ignoring the ADL issue violates prioritization of basic needs, and giving false reassurance violates therapeutic communication standards.
Eliminating incorrect actions ensures the selected intervention is both safe and effective.

Key Concept

Interdisciplinary Collaboration for Fine Motor Deficits and ADLs
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Topics

Collaboration with Interdisciplinary Team

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