A nurse receives a client care assignment from the charge nurse that he believes is unfair. The nurse voices his concern to the charge nurse. The nurse is using which level of communication at this time?

A. A case manager coordinates and manages the overall care of the client, particularly when there are multiple healthcare needs or transitions in care. Given that the client has just experienced a CVA, the case manager could be crucial in coordinating care, arranging for additional services, and ensuring continuity of care, especially since the client lives alone.
B. The client is experiencing wheezing in the upper lobes of the lungs and is receiving supplemental oxygen. A respiratory therapist would be instrumental in evaluating and managing the client's respiratory status, including optimizing oxygen therapy and addressing any issues related to asthma or lung function.
C. There is no mention of diabetes in the client's history or current symptoms. The focus of the client's care is on managing the effects of the CVA and respiratory issues. Therefore, a referral to a diabetes nurse educator is not indicated based on the provided information.
D. The client has flaccid extremities with decreased muscle tone and strength following the CVA. A physical therapist would be essential for assessing and providing therapy to improve mobility, strength, and function in the affected extremities. This referral is appropriate for addressing the physical impairments resulting from the CVA.
E. The client is having difficulty with self-feeding due to decreased muscle tone and strength, which impacts daily activities. An occupational therapist can help with adaptive techniques and strategies for self-care tasks, such as feeding, and provide interventions to improve the client’s ability to perform daily activities independently. This referral is appropriate for addressing functional challenges related to the CVA.
F. An enterostomal therapy nurse specializes in wound care, ostomy management, and incontinence care. There is no indication in the provided information that the client has any issues related to wounds, ostomies, or incontinence. Therefore, a referral to an enterostomal therapy nurse is not indicated based on the current information.

A. Hospice care focuses on providing comfort and quality of life rather than curative treatment. The goal is to manage symptoms and provide supportive care when a cure is no longer possible. Therefore, hospice care typically does not include aggressive treatments.
B. Hospice care is generally initiated when a prognosis indicates that the client is expected to have 6 months or less to live if the illness runs its usual course. The 2-year timeframe mentioned here is too long for standard hospice eligibility, which is based on a more immediate prognosis of terminal illness.
C. Hospice care services often include respite care, which provides caregivers with temporary relief from their caregiving duties. This respite allows caregivers to take personal time, recharge, and manage their own needs, which is an important aspect of supporting those who are caring for terminally ill patients.
D. While hospice care does involve communication with the family about the client's care and condition, the primary focus of hospice care is on providing comfort and support to the patient.