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Zorluk: Çok zorCollaboration with Interdisciplinary Team

A 28-year-old client is preparing for discharge to an inpatient rehabilitation facility following a prolonged acute care stay for full-thickness burns to the bilateral upper extremities, anterior chest, and neck. The client has healing skin grafts, requires continuous pressure garments, and frequently expresses intense fear of permanent physical disfigurement. The client receives supplemental nutrition via a percutaneous endoscopic gastrostomy (PEG) tube but has recently begun oral diet trials. Which interprofessional collaborative actions should the nurse include in the client's plan of care? Select all that apply.

  1. Coordinate with the occupational therapist to evaluate the fit of custom pressure garments and modify the upper extremity splinting schedule.Cevap
  2. Consult the registered dietitian to analyze daily oral caloric intake versus hypermetabolic demands to guide the PEG tube weaning process.Cevap
  3. Facilitate a referral to a clinical psychologist to evaluate for acute stress disorder and address severe body image disturbances.Cevap
  4. D
    Delegate the initial evaluation of the rehabilitation facility's structural safety and specialized equipment availability to the unlicensed assistive personnel (UAP).
  5. E
    Instruct the social worker to comfort the client by assuring them that future reconstructive surgeries will completely restore their pre-injury appearance.
  6. F
    Prioritize finalizing the interfacility transfer documentation before investigating the client's sudden onset of tachypnea and restlessness.

Cevap

The correct actions include coordinating with the occupational therapist for pressure garment and splint evaluation, consulting the registered dietitian for metabolic and PEG weaning management, and referring to a clinical psychologist for trauma and body image support.
The correct collaborative actions align perfectly with the specialized scopes of practice required for complex burn rehabilitation. Occupational therapists are uniquely trained to manage upper extremity contractures using custom splints and pressure garments. Registered dietitians are necessary to manage the high metabolic demands of burn healing and safely calculate the transition from enteral feeding to an oral diet. Clinical psychologists or psychiatric specialists are essential to address the profound psychological trauma and body image disturbances associated with severe burns.

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1
Analyze the client's complex physiological and psychological needs.
The client has upper extremity contracture risks, hypermetabolic nutritional needs (PEG to oral weaning), and severe psychosocial distress regarding disfigurement.
Identifying the specific deficits determines which specialized interdisciplinary team members are required for safe and effective discharge planning.
2
Evaluate each proposed collaboration against the legal and ethical scope of practice for each discipline.
Occupational therapy (splinting/garments), dietetics (nutrition weaning), and psychology (trauma therapy) are matched correctly. Delegating assessment to UAP, using false reassurance, and ignoring ABCs for paperwork are incorrect.
The RN is responsible for ensuring that referrals are appropriate and that delegated tasks do not violate the Nurse Practice Act or standard safety protocols.
3
Select the appropriate multidisciplinary interventions.
The valid interventions are selected, avoiding prioritization, delegation, and therapeutic communication traps.
This confirms a holistic, safe, and collaborative approach to complex client care.

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