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Difficulty: HardCollaboration with Interdisciplinary Team

A pediatric nurse is coordinating the interdisciplinary care plan for a 4-year-old client with autism spectrum disorder who is hospitalized for an acute asthma exacerbation. The client currently exhibits mild expiratory wheezing. The parents express feeling profoundly overwhelmed by the new home nebulizer regimen. Additionally, they report the child has been losing weight at home due to frequently dropping utensils and refusing to eat foods with mixed textures. Which action by the nurse demonstrates appropriate interdisciplinary collaboration and care management?

  1. A
    Delegate the initial evaluation of the child's oral intake and the demonstration of the home nebulizer equipment to the unlicensed assistive personnel (UAP).
  2. B
    Postpone the administration of a prescribed PRN bronchodilator to prioritize a consultation with the child life specialist for medical play.
  3. Request an occupational therapy consultation to evaluate the child's fine motor skills for utensil use and provide interventions for the sensory-based food aversions.Answer
  4. D
    Reassure the parents by stating, "Do not worry about the treatments; the respiratory therapist will explain everything so simply that anyone could do it."

Answer

Request an occupational therapy consultation to evaluate the child's fine motor skills for utensil use and provide interventions for the sensory-based food aversions.
Occupational therapists specialize in promoting independence with activities of daily living (ADLs). Their scope of practice specifically includes evaluating and treating fine motor deficits (such as difficulty grasping utensils) and implementing sensory integration strategies for clients with autism spectrum disorder who experience aversions to food textures. Collaborating with occupational therapy directly addresses the root causes of the child's weight loss in this scenario.

Step-by-Step Solution

1
Analyze the client's clinical presentation and the parents' reported concerns.
The client has respiratory needs (wheezing, new nebulizer regimen) and developmental/nutritional needs (dropping utensils, sensory food aversions, weight loss).
Identifying all active physiological and psychosocial issues is the first step in care coordination.
2
Evaluate the proposed interdisciplinary actions against the principles of prioritization and delegation.
Airway needs (wheezing) must be prioritized over psychosocial needs. Assessments and teaching cannot be delegated to UAPs.
Safe nursing practice requires adherence to the ABCs and legal delegation guidelines.
3
Differentiate between the scopes of practice for allied health professionals regarding the child's feeding difficulties.
Occupational therapy addresses fine motor deficits (utensil use) and sensory processing aversions.
Appropriate interdisciplinary collaboration requires matching the client's specific deficit to the correct specialist's scope of practice.

Key Concept

Collaboration with Interdisciplinary Team
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Collaboration with Interdisciplinary Team

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