A nurse is assisting in the care of a client who had a stroke and is having difficulty swallowing. The nurse should recommend a referral to which of the following members of the interprofessional team?

Rationale:

A. "My advance directives will list what treatments I want if I'm unable to communicate.": Advance directives allow individuals to specify their healthcare preferences in situations where they are incapacitated. This includes decisions about life-sustaining treatments, resuscitation, and other medical interventions.

B. "My advance directives must be signed by my adult child in the presence of a judge.": Advance directives usually require the client’s signature and the signatures of two adult witnesses or notarization, depending on state laws. A judge’s involvement is typically not required.

C. "My family will be informed about my funeral choices in my advance directives.": Funeral or postmortem arrangements are not addressed in advance directives. These documents strictly relate to medical care preferences and decision-making in the event the client becomes unable to speak for themselves.

D. “I can indicate the organs will donate in my advance directives.": While some advance directive forms may include a section about organ donation, formal organ donor registration is typically completed through a driver’s license, organ donor card, or state registry—not as the main purpose of an advance directive.

Rationale:

A. Ask the client to describe the incident: The first step is to gather detailed and accurate information about what happened. This not only allows the nurse to assess the severity and risk of harm but also builds trust with the client. Understanding the specifics of the situation is essential before planning further interventions.

B. Assist the client with developing a safety plan: While crucial for long-term well-being, safety planning should come after assessing the current situation. The nurse must first understand the context of the incident to tailor the plan effectively and ensure it aligns with the client’s readiness and safety.

C. Provide the client with information about local shelters: Offering shelter information is supportive and may be part of discharge or follow-up teaching. However, this should follow the initial assessment, as the client may not yet be ready to consider leaving or may have specific needs not met by general resources.

D. Refer the client to a support group: Support groups are helpful for emotional healing and connection but are not an immediate priority. Without understanding the client’s current circumstances, risk level, and readiness to engage, such a referral may not be appropriate at this stage.