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. Check for seals in the drainage system: Urinary leakage in a client with an indwelling catheter may indicate a break in the closed drainage system. Inspecting for disconnected or loose seals is essential to verify the system’s integrity and ensure proper catheter function, reducing the risk of backflow or infection.

B. Place a waterproof pad under the client's buttocks: This action addresses the symptom of leakage rather than identifying or correcting the cause. While it may help manage moisture, it does not ensure the catheter is functioning properly or prevent further complications.

C. Clip the drainage tubing to the edge of the mattress: Clipping the tubing can obstruct flow and increase the risk of urine retention or reflux. Tubing should be secured loosely and not kinked, with no tension that might disrupt drainage or lead to malfunction.

D. Position the drainage bag below the level of the client's bladder: While proper bag positioning is important to promote gravity drainage, it does not specifically verify safe functioning if leakage is occurring. Ensuring the drainage system is intact is the first step in evaluating catheter function.

Rationale:

A. A client who has narcissistic personality disorder and refuses to be alone in their room: Clients with narcissistic personality disorder typically display a need for admiration and may fear abandonment, but they are not at increased risk for physical injury.

B. A client who has social anxiety disorder and refuses to attend group therapy: Avoidance of social settings is a hallmark of social anxiety disorder. While it may lead to isolation, it does not place the client at increased risk for physical injury.

C. A client who has bipolar disorder and exhibits impulsive behaviour: Impulsivity during manic episodes in bipolar disorder can lead to high-risk activities such as reckless driving, substance use, or unsafe sexual behavior. These behaviors significantly elevate the client’s risk for accidental or intentional physical injury.

D. A client who has panic disorder and exhibits paresthesia: Paresthesia, such as tingling or numbness, is a common symptom during panic attacks but does not directly increase the risk for physical injury. While distressing, it typically resolves and is not associated with unsafe behaviors.