A nurse in a long-term care facility is collecting data for an interprofessional care conference for a client who has Parkinson's disease. Which of the following findings is the priority for the nurse to report at the conference?
The client has difficulty swallowing.
The client reports insomnia.
The client requires additional help to stand.
The client has increased difficulty dressing.
The Correct Answer is A
A. Difficulty swallowing (dysphagia) is the priority because it increases the risk of aspiration, which can lead to aspiration pneumonia, a serious and potentially life-threatening complication for clients with Parkinson's disease.
B. Insomnia, while impacting quality of life, is not as immediately life-threatening as aspiration risk.
C. Needing additional help to stand reflects disease progression but does not carry the immediate risk of a life-threatening complication.
D. Difficulty dressing also indicates disease progression but does not pose an immediate danger to the client’s health.
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Correct Answer is D
Explanation
A. Contacting the provider for instructions could delay immediate resuscitative efforts, which are required in the absence of a DNR order.
B. Consulting with the client’s family may not be effective in an emergency, as the living will is a legal document, and family members cannot override it without a DNR order.
C. Complying with the living will and letting the client expire naturally would be inappropriate without a formal DNR order in place.
D. Calling a code is the correct action because, legally, resuscitative efforts must be initiated in the absence of a written DNR order from the provider, despite the existence of a living will.
Correct Answer is A
Explanation
A. Providing postmortem care is a task that can be delegated to assistive personnel, as it involves following established protocols and does not require clinical judgment.
B. Reinforcing discharge instructions requires clinical knowledge and assessment, making it inappropriate for delegation to an AP.
C. Interpreting deviations in a client's vital signs necessitates nursing judgment and clinical expertise, which an AP does not possess.
D. Inserting an NG tube is a skilled nursing procedure that requires assessment and decision-making, thus it should not be delegated to an AP.