Interprofessional Care and Client Teaching Assignment
AH3: Fall 2022
Brianna Trecartin
Interprofessional collaboration and client teaching are essential components to patient centered care. As future nurses,
it is important to recognize patient’s unique needs across all care settings. These needs should be identified and
planned for early on in the patient’s care.
Instructions: You are the nurse caring for Mr. Frank Garfield. Read through each section of the case study and answer
the questions. Utilize Ch. 2 of the Davis text: Interprofessional Collaboration and Care Coordination to support your
answers. Create a word document and use complete sentences to record your answers. Upload your finished work to
Canvas by the assigned due date.
Case Study Part 1:
Mr. Frank Garfield is a 67-year-old gentleman admitted six days ago after an acute cerebrovascular accident (CVA). The
patient has a history of well-managed hypertension and atrial fibrillation. His home meds include: Lisinopril 5mg PO BID
and Coumadin 5mg PO daily; however, he was out of the country for approximately one month and forgot his Coumadin
prescription at home. He lives with his wife of 46 years, in a two-story house and was functionally independent prior to
admission. The patient now presents with right-sided weakness and aphasia. He is right-handed and now has a deficit to
the right side. He has been placed on four new medications, including an anticoagulant. He has been seen by various
members of the interprofessional care team (ICT). The patient and his wife are Spanish-speaking and are able to carry on
simple conversations in English. The nurse recognizes the need to begin interprofessional collaboration (IC) to develop a
safe discharge plan to return this patient to an optimal level of function and transition to the next level of care.
1. Define interprofessional collaboration in the healthcare setting.
When two or more professionals work together to solve problems or coordinate care.
2. Identify four members of the interprofessional care team that should be involved in Mr. Garfield’s care and
explain why.
Mr. Garfield would benefit from having a translator to translate complicated side effects of medications and the intended plan of care. He
would also benefit from speech therapy to try and alleviate the new onset of aphasia and eating with the right sided weakness. Physical
therapy would also be involved in his care to adjust his living and ADLs to the onset of right sided weakness. A cardiologist would also be
on his care team due to the history of atrial fibrillation and to ensure that his new meds are compatible with his home meds, and diagnosis.
3. What unique cultural needs does Mr. Garfield have and what additional member of the ICT might need to be
involved?
Due to the client being a primarily Spanish-speaker, a translator would ensure culturally competent care. As
well as asking if there are any specific dietary adjustments they would like, or any religious preference. The
answer to this may guide the addition of a pastor and dietician/ nutritionist.
4. With the information you know thus far, what elements of Mr. Garfield’s condition or treatment will you need
to prepare to teach him and his wife before discharge? Identify three elements.
One element that I would educate the client is on medication adherence. The new medications and the
home medications are prescribed to prevent further complications relating to his history. It is important to
take them as prescribed so that he will not have another stroke, or possible MI or PE.
A blood thinner is prescribed, meaning that he will bleed longer with this medication if he gets a scratch,
and it will take longer to clot. He will have to be on bleeding precautions throughout his medication
regimen. He will also have an increased amount of lab visits to check his PT/INR levels and ensure that
the medication is working properly. He should avoid eating vitamin K, as it reduces the efficacy of
warfarin.
The blood thinner is prescribed to reduce the instance of new clots being formed within his body. With his
history, the atrial fibrillation may be increasing his risk for clots and should also be well controlled with
this medication.
Case Study Part 2:
Mr. Garfield is monitored as he slowly demonstrates signs of recovery. His wife expresses concern that she is not sure
she can care for him at home in his present condition but knows that he has expressed a desire to come home. She asks
questions about what to do if his condition takes a turn for the worse because he has told her he “never wants to be on
a machine.” Mr. Garfield does not currently have an advanced directive or living will in writing. If she does take him
home, she has no equipment in the home and does not know anything about his care or medications.
5. How would you respond to Mr. Garfield’s wife regarding her concerns of not being able to care for her husband?
I would educate her on his condition and expected outcomes. I would also mention signs and symptoms to watch for that
would indicate a worsening condition (MI, Stroke, PE, VTE). I would also have them talk to the provider about advanced
directives and if he is interested in consenting to one. Offer home health option if he does not feel confident.
6. What member of the ICT should you involve to help navigate discharge planning for Mr. Garfield?
I would involve social work, to facilitate the availability of the necessary resources in the
hospital and at home.
7. If Mr. Garfield is able to be discharged home, what home equipment and/or support do you anticipate he will
need based on his current condition?
The client will benefit from home health care, follow up appointments. I would encourage the use of assisted walking devices in the home due to
the right sided weakness. This may include a walker or wheelchair depending on his strength and safety. I would recommend a social support
group to help the client cope with their new lifestyle. Home health would be beneficial to help the couple gain confidence in caring for Mr.
Garfield in the home. The client may need a therapist to discuss struggles and alleviate frustration and stress.
Case Study Part 3:
Mr. Garfield’s discharge plan is discussed in rounds. He continues to be hypertensive during the hospitalization, so he
will need to go home with a prescription for Metoprolol 25mg PO BID and close monitoring. Social work will work on
insurance support for his prescriptions. An interpreter is available to help the nurse, pharmacist, and Registered
Dietician with patient teaching related to his hypertension, diet, and the action/frequency/side effects of the
medications. Teach-back is used to ensure that Mrs. Garfield is retaining the teaching provided. Mrs. Garfield decides to
take the patient home.
8. Explain one way you can teach Mrs. Garfield to care for her husband at home while he is still in the hospital.
I would demonstrate the proper use of an assistive walking devices to ensure her husband stays
safe when ambulating.
9. Explain the teach-back method.
Once educating an individual, you ask them to restate the information provided to ensure understanding.
10. Using the teach-back method, explain how you would teach Mr. Garfield and his wife about one of the following
related to his condition: his hypertension, acute cerebrovascular accident, diet, or the action/frequency/side
effects of his antihypertensive prescription. Respond to this question as if you were speaking directly to Mr.
Garfield and his wife (this response should be a minimum of 150 words).
Hello, you have been prescribed Metoprolol for your hypertension Mr. Garfield. This medication relaxes
the blood vessels in your body, which also decreases your blood pressure and heart rate. Your doctor
wants you to take this medication twice a day. It is important that you do not stop this medication
suddenly, it should be tapered off slowly. This medication should not be taken if you have a low blood
pressure (lower than 90/60) or heart rate (under 60), doing so may make you pass out or become
unconscious. Metoprolol has some side effects to it. Some common side effects of Metoprolol are
dizziness, shortness of breath, diarrhea, itching, rash, low blood pressure, and low heart rate. Call your
doctor or go to the Emergency room if he passes out and does not wake back up/ becomes very confused
suddenly, or if you feel more pain in your chest, if your vision becomes blurry, if you become very
sweaty or very tired all of a sudden. Now can you explain why you are taking this medication, and what
to look out for with this medication? How often should you take your medication? When should you not
take Metoprolol? Great job! Do you have any other questions?
Assignment Rubric
Each question will be graded for complete responses as well are correct responses. To achieve points for each question,
the response must be both complete and correct. No partial credit will be given.
Each question is weighted as follows:
Question Number
Possible Points
1
2
3
4
5
6
7
8
9
10
Total Possible:
2.5
5
5
5
5
2.5
5
5
5
10
50