A nurse is contributing to the plan of care for a client who has dysphagia and is pocketing food in their cheeks during meals. Which of the following interventions should the nurse recommend?
Administer liquids to the client using a syringe.
Elevate the head of the client's bed to 45° during meals.
Instruct the client to tilt their head back when swallowing.
Request a speech therapist consult from the provider.
The Correct Answer is D
A) Administer liquids to the client using a syringe:
Administering liquids using a syringe may not address the underlying issue of food pocketing in the client's cheeks during meals. While syringe feeding may be necessary for clients with severe dysphagia, it does not address the need for comprehensive evaluation and intervention by a speech therapist.
B) Elevate the head of the client's bed to 45° during meals:
Elevating the head of the bed during meals is a standard intervention to help prevent aspiration in clients with dysphagia. While this intervention may be appropriate, it may not directly address the issue of food pocketing in the client's cheeks. Therefore, it is not the most comprehensive intervention for this specific problem.
C) Instruct the client to tilt their head back when swallowing:
Tilting the head back when swallowing is not a recommended intervention for clients with dysphagia. In fact, this maneuver can increase the risk of aspiration, as it can cause food or liquid to enter the airway. Therefore, this intervention would not be appropriate and could potentially exacerbate the client's swallowing difficulties.
D) Request a speech therapist consult from the provider:
This is the most appropriate intervention for addressing the client's dysphagia and food pocketing. Speech therapists are trained to assess and treat swallowing disorders, including pocketing of food in the cheeks. They can conduct a comprehensive evaluation of the client's swallowing function and develop individualized interventions to address the underlying causes of dysphagia. Therefore, requesting a speech therapist consult is the most effective way to manage this issue and improve the client's swallowing safety and efficiency.
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Correct Answer is C
Explanation
A) The surgeon should delay surgery until he can obtain informed consent from a parent:
This option is not feasible in emergencies where immediate surgical intervention is required to save the client's life or prevent further harm. Delaying surgery could jeopardize the client's health and violate the principle of beneficence, which prioritizes the client's well-being.
B) The client's pediatrician can obtain implied consent:
While pediatricians often play a role in providing medical care to minors, implied consent typically pertains to emergency situations where immediate intervention is necessary, and obtaining consent from a parent or legal guardian is not possible. In this scenario, the surgeon, rather than the pediatrician, would be responsible for obtaining consent.
C) The surgeon can proceed with the surgery by invoking implied consent:
In emergency situations where immediate surgical intervention is required to prevent harm or save a client's life, healthcare providers may proceed with treatment under the doctrine of implied consent. Implied consent assumes that a reasonable person would consent to necessary medical treatment if they were able to do so. However, the specific legal requirements for invoking implied consent may vary depending on jurisdiction and institutional policies.
D) The surgeon can obtain informed consent from the client's adult cousin:
While obtaining consent from a close family member may be necessary in certain situations, such as when a parent is unavailable, it may not be legally sufficient in emergency situations where immediate action is required. Additionally, the legal authority to provide consent may vary depending on the jurisdiction and the client's age. In this scenario, relying on informed consent from the client's adult cousin could delay necessary surgical intervention and may not be appropriate without further legal clarification.
Correct Answer is B
Explanation
A) Examine personal values:
While examining personal values is important in ethical decision-making, it is not the first step in addressing this particular ethical dilemma. Understanding personal values comes after gathering relevant facts and understanding the situation fully.
B) Collect the relevant facts:
This is the most appropriate initial step when facing an ethical dilemma. Gathering relevant information about the child's condition, the prescribed treatment, and the reasons for the parents' refusal is crucial for making informed decisions and developing a plan of action.
C) Create a plan of action:
Creating a plan of action is an important step in addressing the ethical dilemma, but it should come after collecting all relevant facts. Without a clear understanding of the situation, any plan of action may be incomplete or ineffective.
D) Agree on a desired outcome:
While determining a desired outcome is essential, it should be based on a thorough understanding of the situation, which comes from collecting relevant facts. Agreeing on an outcome before fully assessing the situation may lead to premature or uninformed decisions.
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