A nurse is caring for a client who has severe rheumatoid arthritis in her hands and is unable to feed herself. For which of the following health care team members should the nurse request a referral from the provider?

A. The client is consuming 25% of their meals.

Poor nutritional intake can lead to complications over time, but it is not the most immediate concern compared to other options. This finding is important but not the highest priority.

B. The client coughs frequently while eating.

Frequent coughing while eating can indicate dysphagia (difficulty swallowing), which increases the risk of aspiration. Aspiration can lead to serious complications like aspiration pneumonia, which is life-threatening. This is the nurse’s priority finding because it poses an immediate risk to the client’s airway and respiratory status.

C. The client's blood pressure is 142/94 mm Hg.

The blood pressure is elevated, which is concerning, especially in a post-stroke client. However, it is not critically high and does not present an immediate threat compared to the risk of aspiration.

D. The client leans to the left side while sitting.

Leaning to the left side while sitting could indicate poor balance or proprioception, which increases the risk of falls. While important to address, it is not as immediately critical as the risk of aspiration.

A. Social worker:

While social workers play a crucial role in addressing various aspects of a patient's well-being, such as psychosocial needs and support systems, they may not be the primary healthcare team member to address the specific issue of a client with severe rheumatoid arthritis being unable to feed herself.

B. Physician assistant:

Physician assistants are medical professionals who work under the supervision of a physician. While they contribute to the overall care of the patient, they may not be the primary specialist for addressing the functional limitations and specific needs associated with severe rheumatoid arthritis.

C. Physical therapist:

Physical therapists primarily focus on physical rehabilitation, movement, and mobility. While they may be involved in the overall care plan for a patient with rheumatoid arthritis, the specific issue of hand function and activities of daily living, such as feeding, is more directly addressed by occupational therapists.

D. Occupational therapist:

The correct choice. Occupational therapists specialize in helping individuals regain or improve their ability to perform daily activities, such as feeding, dressing, and grooming. In the case of severe rheumatoid arthritis affecting the hands, an occupational therapist can work with the client to develop strategies, adaptive equipment, and exercises to enhance hand function and promote independence in activities of daily living.