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Difficulty: HardCollaboration with Interdisciplinary Team

A nurse is participating in interdisciplinary care rounds for a client who sustained a complex pelvic fracture and bilateral wrist fractures in a motor vehicle collision. The client is immobilized in bed, exhibits acute agitation, and is entirely dependent on staff for meals due to the upper extremity injuries. Which nursing action demonstrates appropriate care management and interprofessional collaboration?

  1. Consulting an occupational therapist to evaluate the client for custom hand splints and adaptive feeding equipment.Answer
  2. B
    Delegating the ongoing assessment of capillary refill and peripheral pulses in the client's fingers to the unlicensed assistive personnel (UAP).
  3. C
    Prioritizing a referral to a behavioral health specialist for the agitation while dismissing a new onset of mild tachycardia and narrowing pulse pressure.
  4. D
    Reassuring the client by stating, "The physical therapist will ensure you make a complete recovery, so there is no need to be upset."

Answer

Consulting an occupational therapist to evaluate the client for custom hand splints and adaptive feeding equipment.
Occupational therapists specialize in assisting clients to regain independence in activities of daily living (ADLs) through the rehabilitation of fine motor skills, upper extremity function, and the provision of customized adaptive equipment (like splints and adapted utensils). Given the client's bilateral wrist fractures and inability to self-feed, this is the most accurate and beneficial interdisciplinary referral.

Step-by-Step Solution

1
Analyze the client's clinical presentation and injuries.
The client has a high-risk orthopedic injury (pelvic fracture) and bilateral upper extremity limitations (wrist fractures) causing a deficit in self-care.
Identifying the physiological risks and functional deficits is the first step in determining appropriate nursing actions and interdisciplinary referrals.
2
Evaluate the proposed allied health referrals based on scope of practice.
Occupational therapy (OT) is correctly identified as the discipline responsible for upper extremity rehabilitation and adapting activities of daily living (ADLs).
Effective interprofessional collaboration requires matching the client's specific functional deficits to the correct allied health specialty.
3
Critically analyze the distractor actions for safety, delegation, and communication principles.
The distractors involve unsafe delegation of assessments, failure to recognize early shock symptoms (prioritization failure), and nontherapeutic communication.
The nurse must ensure that while coordinating care, fundamental safety principles regarding the ABCs (airway, breathing, circulation) and scope of practice are strictly maintained.

Key Concept

Interprofessional collaboration involves accurately utilizing allied health scopes of practice (such as Occupational Therapy for ADLs and fine motor skills) while maintaining strict adherence to safe delegation, therapeutic communication, and physiological prioritization.
Estimated Time:1m 30s
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Collaboration with Interdisciplinary Team

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