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Zorluk: KolayCollaboration with Interdisciplinary Team

A client with amyotrophic lateral sclerosis (ALS) is hospitalized and has recently started coughing and clearing their throat frequently during meals. The client's spouse is visibly anxious and asks the nurse if the client is going to choke. Which action by the nurse is the most appropriate to address these concerns?

  1. Request a consultation with a speech-language pathologist to evaluate the client's swallowing function.Cevap
  2. B
    Instruct the unlicensed assistive personnel (UAP) to perform an initial bedside swallowing assessment.
  3. C
    Prioritize providing the spouse with pamphlets about ALS support groups before addressing the client's airway safety.
  4. D
    Reassure the spouse by stating, "Try not to worry; our medical team will ensure nothing bad happens."

Cevap

The most appropriate action is to request a consultation with a speech-language pathologist to formally evaluate the client's swallowing function.
Clients with progressive neuromuscular diseases, such as ALS, are at an increased risk for developing dysphagia. Coughing during meals is a cardinal sign of potential aspiration. The most appropriate collaborative action is to obtain a consultation with a speech-language pathologist (SLP), as they are the interdisciplinary experts trained to evaluate swallowing safety and recommend appropriate diet modifications.

Adım Adım Çözüm

1
Identify the client's primary physiological risk.
The client is demonstrating signs of dysphagia (coughing during meals), which creates a high risk for aspiration.
Recognizing the immediate physical threat dictates the necessary clinical intervention.
2
Select the appropriate interdisciplinary team member for consultation.
A speech-language pathologist (SLP) is identified as the specialist needed for this complication.
SLPs are specially trained to evaluate swallowing function and recommend safe dietary modifications or strategies.
3
Rule out unsafe or nontherapeutic nursing actions.
Delegating assessments, providing false reassurance, and ignoring ABC priorities are rejected.
Safe nursing practice requires maintaining accountability for assessments, using therapeutic communication, and prioritizing physiological needs first.

Anahtar Kavram

Interprofessional collaboration for dysphagia management
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