The nurse is caring for a patient with sepsis. The nurse includes potential complication: septic shock in the plan of care. Why is this nursing diagnosis considered to be a collaborative problem?

Choice A reason: This is an incorrect choice because gently trimming the patient’s toenails after soaking the feet in warm soapy water is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Trimming the toenails can be risky for the diabetic patient, as it can cause bleeding, infection, or injury to the nail bed or surrounding skin. The nurse should avoid cutting the toenails of the diabetic patient, unless instructed by a podiatrist.

Choice B reason: This is an incorrect choice because using a pumice stone to smooth roughened areas of skin on the patient’s feet is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A pumice stone is a porous rock that can be used to exfoliate the skin and remove dead cells. However, it can also damage the skin and cause abrasions, irritation, or infection. The nurse should be careful when using a pumice stone on the diabetic patient, and avoid rubbing too hard or too often.

Choice C reason: This is an incorrect choice because liberally applying lotion to the patient's feet especially between the toes is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Applying lotion to the feet can help to moisturize and soften the skin, but it can also create a moist environment that can promote fungal growth and infection. The nurse should apply lotion sparingly to the feet of the diabetic patient, and avoid applying it between the toes.

Choice D reason: This is the correct choice because obtaining a consultation for a podiatrist to assess the feet and provide nail care is the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A podiatrist is a specialist who can diagnose and treat foot problems, such as nail disorders, skin conditions, or infections. The podiatrist can safely and effectively trim the toenails of the diabetic patient, and provide education and advice on foot care and prevention of complications. The nurse should refer the diabetic patient to a podiatrist at least once a year, or more often if needed.

Choice A reason: This is an incorrect choice because "When did you first seek health care for your symptoms?" is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of an open-ended question, which is another communication technique that involves asking questions that require more than a yes or no answer and elicit more information from the speaker.

Choice B reason: This is an incorrect choice because "I am sure the doctor will answer all of your questions shortly." is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a reassurance, which is another communication technique that involves expressing confidence or support to the speaker and alleviating their anxiety or fear.

Choice C reason: This is the correct choice because "I completely understand. Can you tell me more?" is an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a verbal cue, which involves using words or phrases that show empathy, interest, or agreement, and invite the speaker to elaborate or clarify their message.

Choice D reason: This is an incorrect choice because "Try not to worry. I'm sure that you will be just fine." is not an example of back-channeling. Back-channeling is a communication technique that involves using verbal or non-verbal cues to indicate that the listener is paying attention and encouraging the speaker to continue. This statement is an example of a false reassurance, which is a communication barrier that involves making unrealistic or unfounded promises or predictions to the speaker and dismissing their concerns or feelings.