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Difficulty: MediumCollaboration with Interdisciplinary Team

A client hospitalized for a severe exacerbation of rheumatoid arthritis is medically stable and preparing to return home. During the morning assessment, the client states, "I am terrified of going home. My hands are so stiff and painful that I can barely hold my toothbrush or button my own clothes." Which action by the nurse represents the most appropriate interdisciplinary collaboration?

  1. Initiate a referral to occupational therapy for evaluation of fine motor skills and adaptive equipment needs.Answer
  2. B
    Request a physical therapy consultation to develop a progressive resistance exercise program for upper extremity strength.
  3. C
    Delegate the task of teaching the client how to use modified eating utensils to the unlicensed assistive personnel.
  4. D
    Reassure the client that these limitations are temporary and will resolve once the prescribed disease-modifying agents take effect.

Answer

Initiate a referral to occupational therapy for evaluation of fine motor skills and adaptive equipment needs.
The correct answer accurately identifies the role of the occupational therapist (OT). OTs are specifically trained to evaluate fine motor deficits and assist clients with impaired dexterity in mastering Activities of Daily Living (ADLs). They prescribe and teach the use of adaptive devices, directly addressing the client's anxiety about brushing teeth and dressing.

Step-by-Step Solution

1
Analyze the client's specific clinical deficit and expressed need.
The client is experiencing bilateral hand stiffness and pain, leading to an inability to perform fine motor Activities of Daily Living (ADLs) such as brushing teeth and buttoning clothes.
Identifying the exact nature of the impairment is required to determine which allied health professional possesses the correct scope of practice to assist.
2
Differentiate between the scopes of practice of the interdisciplinary team members.
Physical therapy focuses on gross motor function and mobility; occupational therapy focuses on fine motor function, ADLs, and adaptive equipment; unlicensed personnel assist with basic care but cannot teach or evaluate.
Matching the client's deficit (fine motor ADLs) to the correct specialist ensures safe and effective care coordination.
3
Select the intervention that addresses the physical need while maintaining therapeutic communication.
Referring to occupational therapy directly addresses the ADL deficits, whereas offering false reassurance dismisses the client's immediate discharge concerns.
The nurse must act as an advocate by mobilizing the appropriate interdisciplinary resources to prepare the client for a safe discharge.

Key Concept

Collaboration with Interdisciplinary Team (Scope Differentiation)
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Topics

Collaboration with Interdisciplinary Team

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