Scenario Analysis: This scenario presents a common challenge in perianesthesia nursing where a critical patient need arises, requiring immediate attention and resource allocation. The challenge lies in balancing the urgent requirement for specialized care with the existing workload and the need to maintain patient safety and regulatory compliance. Effective leadership, delegation, and interprofessional communication are paramount to navigating such situations without compromising patient outcomes or violating professional standards. Correct Approach Analysis: The best approach involves a leader who immediately assesses the situation, prioritizes patient needs based on acuity, and then delegates tasks to appropriately qualified staff, ensuring clear communication of expectations and rationale. This leader would proactively engage the interprofessional team, including physicians and other nurses, to collaboratively develop a plan of care. This aligns with principles of effective nursing leadership, which mandate responsible delegation, patient advocacy, and collaborative practice to ensure optimal patient outcomes. Regulatory frameworks emphasize the importance of a registered nurse’s judgment in assessing patient needs and assigning care, ensuring that delegation is appropriate and that the delegatee possesses the necessary skills and competencies. Ethical guidelines further support this by stressing the nurse’s duty to provide safe and effective care, which includes coordinating care and utilizing resources efficiently. Incorrect Approaches Analysis: One incorrect approach involves the leader immediately leaving the current patient to attend to the new critical situation without first ensuring adequate coverage or communication for the patient requiring immediate attention. This fails to uphold the principle of continuity of care and can lead to patient neglect or adverse events for the patient being left unattended. It also demonstrates poor leadership by not effectively managing existing responsibilities before taking on new ones. Another incorrect approach is to delegate the critical patient’s care to a less experienced staff member without adequate supervision or a clear understanding of their capabilities, or to delegate tasks that are beyond their scope of practice. This violates principles of safe delegation and can place the patient at significant risk. It also fails to acknowledge the leader’s ultimate responsibility for the patient’s care and the appropriateness of the delegation. A further incorrect approach is to attempt to manage the situation solely through informal communication channels or by assuming other team members are aware of the critical need without explicit confirmation. This can lead to miscommunication, delays in care, and a breakdown in interprofessional collaboration. Effective communication requires clear, concise, and documented exchanges to ensure all team members are informed and aligned. Professional Reasoning: Professionals should employ a structured decision-making framework that begins with a rapid assessment of the situation and patient acuity. This should be followed by a clear understanding of available resources and staff competencies. The leader must then prioritize tasks, delegate appropriately based on scope of practice and skill level, and ensure clear, direct communication with all involved parties. This process emphasizes patient safety, regulatory compliance, and effective teamwork.

This scenario is professionally challenging due to the inherent vulnerability of the pediatric patient, the potential for rapid physiological changes in the perioperative period, and the need for continuous, multi-system assessment across a broad age range. The nurse must integrate knowledge of normal pediatric development with potential pathological deviations, interpret subtle cues, and anticipate complications, all while adhering to established standards of care and ethical principles. The rapid progression of symptoms in a young child necessitates prompt and accurate diagnostic interpretation and timely intervention. The best approach involves a comprehensive, systematic, and age-appropriate assessment that prioritizes airway, breathing, circulation, and neurological status, while also considering pain management and potential sources of infection or fluid imbalance. This approach aligns with established perianesthesia nursing standards of practice, which emphasize a holistic and vigilant assessment of the pediatric patient. Specifically, it adheres to the principles of patient safety and the ethical obligation to provide competent, evidence-based care. The continuous monitoring of vital signs, oxygen saturation, and neurological status, coupled with a thorough review of the patient’s history and surgical procedure, allows for early detection of deviations from baseline and facilitates prompt intervention. This proactive stance is crucial in preventing adverse outcomes in this vulnerable population. An incorrect approach would be to solely rely on the initial vital signs without considering the patient’s overall presentation and developmental stage. This fails to acknowledge that subtle changes in behavior, activity level, or responsiveness can be early indicators of distress in children, which may not be immediately reflected in standard vital signs. Furthermore, neglecting to assess for pain or discomfort, or failing to consider the impact of the surgical procedure on the child’s physiological state, represents a significant lapse in comprehensive care and a deviation from best practice. Another incorrect approach would be to delay intervention based on the assumption that the child will spontaneously improve without further assessment or diagnostic measures. This approach disregards the rapid decompensation that can occur in pediatric patients and the critical need for timely management of emergent conditions. It also fails to uphold the ethical principle of beneficence, which mandates acting in the best interest of the patient. Finally, an approach that focuses only on one aspect of the assessment, such as respiratory status, while neglecting other critical systems like circulation or neurological function, is incomplete and potentially dangerous. A truly comprehensive assessment requires a multi-system evaluation to identify all potential problems and ensure the patient’s stability. The professional reasoning framework for such situations involves a cyclical process of assessment, diagnosis, planning, intervention, and evaluation. It requires critical thinking, clinical judgment, and effective communication with the healthcare team. Professionals should always prioritize patient safety, adhere to established protocols and standards of care, and advocate for the patient’s needs, especially when dealing with vulnerable populations like pediatric patients.

The efficiency study reveals a need to streamline the process for candidates seeking to enter the Comprehensive Perianesthesia Nursing Fellowship. This scenario is professionally challenging because it requires balancing the need for efficient candidate processing with the absolute necessity of upholding the integrity and purpose of the fellowship exit examination. Careful judgment is required to ensure that eligibility criteria are applied consistently and fairly, without compromising the high standards expected of fellows. The best approach involves a thorough review of the candidate’s documented perianesthesia nursing experience and educational background against the explicitly stated eligibility requirements for the fellowship and its exit examination. This ensures that only individuals who have met the foundational prerequisites, as defined by the fellowship’s governing body and relevant professional standards for advanced perianesthesia practice, are permitted to sit for the examination. This approach is correct because it directly aligns with the purpose of the exit examination, which is to validate the advanced knowledge and skills acquired during the fellowship. Adherence to documented eligibility criteria prevents the examination from being devalued by the inclusion of candidates who have not undergone the prescribed training or gained the requisite experience, thereby upholding professional standards and the credibility of the fellowship. An incorrect approach would be to permit candidates to sit for the examination based solely on a verbal assertion of having “sufficient experience” without independent verification. This fails to adhere to the established eligibility framework, potentially allowing individuals who do not meet the objective standards to proceed, thereby undermining the examination’s purpose of assessing fellowship-specific competencies. Another incorrect approach would be to waive certain eligibility requirements for candidates who are perceived as having strong potential or who are highly recommended by their current supervisors, without a formal process for evaluating such exceptions against the fellowship’s stated goals. This introduces subjectivity and inconsistency, potentially creating an unfair advantage and compromising the standardized nature of the eligibility process. A further incorrect approach would be to focus primarily on the candidate’s current employer’s reputation rather than their individual qualifications and documented experience. While an employer’s standing can be an indicator, it does not substitute for the specific perianesthesia nursing experience and educational attainment mandated by the fellowship’s eligibility criteria. The professional reasoning framework for such situations should involve a commitment to transparency, fairness, and adherence to established guidelines. Professionals must prioritize objective assessment against defined criteria, ensuring that any deviations are handled through a formal, documented process that maintains the integrity of the program. This involves understanding the ‘why’ behind each eligibility requirement and ensuring that the examination serves its intended purpose of certifying advanced competency.

Scenario Analysis: This scenario is professionally challenging because it involves a conflict between a patient’s stated wishes, which may be influenced by external factors, and the nurse’s professional judgment regarding patient safety and the standard of care. The nurse must navigate the ethical principles of autonomy and beneficence, while also adhering to professional nursing standards and institutional policies. The urgency of the situation, requiring a decision about medication administration, adds to the complexity. Correct Approach Analysis: The best professional approach involves a structured, ethical decision-making process that prioritizes patient safety and informed consent. This begins with a thorough assessment of the patient’s capacity to make decisions, considering their current mental state, understanding of the situation, and the potential consequences of their refusal. If the patient is deemed to have capacity, their autonomy must be respected, and the nurse should engage in a detailed discussion about the risks and benefits of the medication, exploring the underlying reasons for their refusal. If the patient lacks capacity, or if their refusal poses an immediate and significant threat to their well-being, the nurse must then consult with the healthcare team, including the physician and potentially a patient advocate or ethics committee, to determine the best course of action, which may involve seeking a surrogate decision-maker or proceeding with necessary treatment under specific legal and ethical guidelines. This approach upholds the patient’s rights while ensuring their safety and adherence to professional nursing standards. Incorrect Approaches Analysis: One incorrect approach is to immediately administer the medication against the patient’s expressed wishes, overriding their autonomy without a thorough assessment of their capacity or exploration of their reasons for refusal. This violates the principle of patient autonomy and could lead to a breach of trust and potential legal repercussions. Another incorrect approach is to simply document the patient’s refusal and take no further action, even if the nurse has concerns about the patient’s capacity or the potential for harm. This abdication of professional responsibility fails to uphold the principle of beneficence and could result in patient harm, violating the nurse’s duty of care. A third incorrect approach is to dismiss the patient’s concerns as unfounded without further investigation or discussion. This demonstrates a lack of empathy and a failure to engage in therapeutic communication, potentially alienating the patient and preventing a collaborative decision-making process. Professional Reasoning: Professionals should employ a systematic decision-making framework that includes: 1. Assessment: Gather all relevant information about the patient, the situation, and the proposed intervention. 2. Diagnosis: Identify the core ethical and clinical issues. 3. Planning: Develop a plan of action that considers ethical principles, professional standards, and patient preferences. 4. Implementation: Carry out the plan, continuously monitoring and evaluating its effectiveness. 5. Evaluation: Reflect on the outcome and learn from the experience. In this case, the framework would guide the nurse through assessing capacity, communicating with the patient, and consulting with the team if necessary, ensuring a patient-centered and ethically sound decision.

This scenario is professionally challenging because it requires the perianesthesia nurse to navigate a situation where a patient’s expressed wishes conflict with the perceived best interests of the patient as interpreted by the family, all within the context of ensuring patient safety and upholding ethical principles. The nurse must balance patient autonomy with the duty of care, while also managing family dynamics and potential legal implications. Careful judgment is required to avoid compromising patient rights or creating a situation that could lead to adverse outcomes. The best approach involves a structured, patient-centered process that prioritizes direct communication with the patient and adherence to their documented wishes, while also facilitating communication with the family. This approach begins with a thorough review of the patient’s advance directives and any existing power of attorney for healthcare. The nurse should then engage in a private, empathetic conversation with the patient to confirm their understanding and current wishes, ensuring they are competent to make decisions. Simultaneously, the nurse should facilitate a discussion between the patient and their family, with the patient’s consent, to explain the patient’s wishes and the rationale behind them. If the patient is deemed incapacitated, the nurse must then rely on the legally designated healthcare proxy and the patient’s previously expressed wishes, documented in advance directives, as the primary guide for decision-making, while still attempting to involve the family in a supportive role. This aligns with ethical principles of patient autonomy, beneficence, and non-maleficence, and is supported by professional nursing standards that emphasize patient advocacy and informed consent. An incorrect approach would be to prioritize the family’s immediate emotional distress or perceived best interests over the patient’s documented wishes and autonomy, especially if the patient is competent. This fails to uphold the fundamental ethical principle of patient autonomy and could lead to a violation of the patient’s rights. Another incorrect approach would be to unilaterally make a decision without attempting to clarify the patient’s current wishes or involve them in the process, even if they are deemed competent. This bypasses essential steps in ethical decision-making and patient advocacy. Finally, disregarding advance directives or the legally appointed healthcare proxy in favor of a family member’s opinion, even if that family member is vocal, represents a significant ethical and potentially legal failure, as it undermines established legal and ethical frameworks for patient care. Professionals should employ a decision-making framework that begins with identifying the core ethical conflict. This is followed by gathering all relevant information, including patient preferences, advance directives, family concerns, and clinical data. Next, the nurse should identify stakeholders and their perspectives. The nurse then evaluates available options based on ethical principles, professional standards, and legal requirements. The chosen course of action should be implemented, and its effectiveness monitored, with ongoing reassessment and communication. In situations involving conflicting wishes, a structured approach that prioritizes patient autonomy and documented preferences, while facilitating communication and seeking clarification, is paramount.

This scenario is professionally challenging because it involves a candidate’s performance on a high-stakes exit examination, directly impacting their career progression and the institution’s commitment to rigorous standards. The fellowship director must balance fairness to the candidate with the integrity of the examination process and the established policies. Careful judgment is required to ensure that any decision regarding retakes or appeals is consistent, equitable, and adheres strictly to the fellowship’s stated blueprint, weighting, scoring, and retake policies. The best professional approach involves a thorough review of the candidate’s performance against the established blueprint and scoring rubric, followed by a transparent application of the fellowship’s retake policy. This approach ensures that decisions are objective, evidence-based, and aligned with the program’s stated commitment to fair assessment. It upholds the integrity of the examination by ensuring that all candidates are evaluated using the same criteria and that retake opportunities are provided only as stipulated in the official policy. This demonstrates respect for the candidate while maintaining the rigor of the fellowship. An incorrect approach would be to grant a retake based solely on the candidate’s expressed disappointment or perceived unfairness without a systematic review of their performance against the scoring criteria. This fails to uphold the established scoring and retake policies, potentially creating a precedent for subjective decision-making and undermining the validity of the examination process. It also fails to provide the candidate with a clear understanding of why their performance did not meet the passing standard, hindering their ability to improve. Another incorrect approach would be to dismiss the candidate’s concerns entirely without any form of review, even if the retake policy is clear. While adherence to policy is crucial, a complete dismissal can be perceived as a lack of empathy and may lead to a perception of unfairness, even if the policy was technically followed. A more professional approach would involve acknowledging the candidate’s feelings while still grounding the decision in the established policies and performance data. Finally, an incorrect approach would be to modify the scoring rubric or retake criteria retroactively to accommodate the candidate’s performance. This fundamentally compromises the integrity of the examination and the blueprint. It is unethical to alter established standards after the assessment has taken place, as it invalidates the original evaluation and creates an unfair advantage. The professional decision-making process for similar situations should involve: 1) Understanding and clearly articulating the fellowship’s blueprint, weighting, scoring, and retake policies. 2) Objectively evaluating the candidate’s performance against these established criteria. 3) Communicating the results and the rationale for any decision clearly and transparently to the candidate. 4) Following the established appeal or review process if one exists, ensuring it is also applied consistently.

Scenario Analysis: This scenario is professionally challenging because it requires the nurse to balance the patient’s immediate comfort and expressed wishes with the established evidence-based protocols for post-operative pain management and the potential for opioid-induced respiratory depression. The nurse must critically assess the patient’s subjective report of pain against objective signs and symptoms, while also considering the risks and benefits of escalating opioid therapy. Failure to adequately manage pain can lead to patient distress and delayed recovery, while overtreatment can lead to serious adverse events. Correct Approach Analysis: The best professional approach involves a comprehensive assessment of the patient’s pain, including its location, quality, intensity, and any aggravating or alleviating factors. This assessment should be followed by a review of the patient’s current pain management regimen, including the type, dose, and timing of analgesics administered. The nurse should then consult available evidence-based guidelines for post-operative pain management, which typically advocate for a multimodal approach that may include non-opioid analgesics, regional anesthesia, and judicious use of opioids. Escalation of opioid therapy should be guided by the patient’s response to current interventions and a careful consideration of potential side effects, particularly respiratory depression. This approach aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm), as well as professional nursing standards that mandate evidence-based practice and patient advocacy. Incorrect Approaches Analysis: Administering a higher dose of the current opioid analgesic without a thorough reassessment of the patient’s pain and a review of evidence-based guidelines for pain management is professionally unacceptable. This approach risks oversedation and respiratory depression, violating the principle of non-maleficence. It also fails to explore alternative or complementary pain management strategies that might be more effective and safer, thus not fully upholding the principle of beneficence. Delaying further pain management interventions until the next scheduled medication time, despite the patient’s reported severe pain, is also professionally unacceptable. This neglects the patient’s immediate suffering and can lead to increased anxiety and distress, potentially impacting recovery. It fails to adequately address the patient’s expressed need for relief and may violate the ethical duty to alleviate suffering. Focusing solely on the patient’s verbal report of pain and immediately escalating to a stronger opioid without considering other contributing factors or potential adverse effects is a flawed approach. While patient self-report is crucial, it must be integrated with objective data and a comprehensive understanding of pain management principles to ensure safe and effective care. This approach could lead to inappropriate medication use and potential harm. Professional Reasoning: Professionals should utilize a systematic decision-making framework that begins with a thorough and ongoing patient assessment. This includes subjective reporting, objective signs, and a review of the patient’s medical history and current treatment plan. Next, they should consult relevant evidence-based practice guidelines and institutional protocols. This is followed by identifying potential interventions, evaluating their risks and benefits in the context of the individual patient, and then implementing the chosen intervention. Finally, continuous evaluation of the patient’s response to the intervention and subsequent adjustments to the care plan are essential. This iterative process ensures patient safety and optimizes outcomes.

The analysis reveals a common yet critical challenge in perianesthesia nursing: ensuring accurate, timely, and compliant clinical documentation within an electronic health record (EHR) system, especially when faced with time constraints and potential system limitations. The professional challenge lies in balancing the immediate need for patient care with the long-term requirements of legal, regulatory, and ethical documentation standards. Missteps can lead to patient safety risks, legal repercussions, and audit failures. Careful judgment is required to prioritize actions that uphold both patient well-being and regulatory adherence. The best approach involves meticulously documenting all critical patient information, including the administration of medications, vital signs, and any patient responses or adverse events, directly into the EHR as soon as feasible. This aligns with the principles of accurate and contemporaneous charting, which is a cornerstone of patient safety and legal defensibility. Regulatory bodies, such as those overseeing healthcare quality and patient rights, emphasize the importance of complete and accurate records that reflect the care provided. Furthermore, professional nursing standards mandate that documentation be a true and faithful representation of the patient’s condition and the interventions performed. Utilizing the EHR’s built-in functionalities for medication reconciliation and allergy verification, even if it requires a brief pause, is crucial for preventing medication errors and ensuring patient safety, a paramount ethical and regulatory obligation. An incorrect approach would be to rely on verbal communication of critical medication details to the next shift without also documenting them in the EHR. This creates a significant gap in the official record, making it impossible to verify what was communicated and potentially leading to medication errors if the information is lost or misinterpreted. This fails to meet the regulatory requirement for a complete and accurate written record of patient care. Another unacceptable approach is to delay charting all but the most basic vital signs until after the patient has been discharged from the recovery area. This practice compromises the ability to track patient progress in real-time, hinders timely intervention if complications arise, and violates the principle of contemporaneous charting, which is essential for legal and clinical integrity. Finally, omitting documentation of a patient’s subjective complaints, such as pain or nausea, because the nurse believes they are minor or will resolve, is a failure to capture the full clinical picture. Patient-reported symptoms are vital data points that inform ongoing care and can indicate developing issues, and their omission represents a significant ethical and regulatory lapse in comprehensive patient assessment and documentation. Professionals should employ a decision-making framework that prioritizes patient safety and regulatory compliance. This involves understanding the core requirements of clinical documentation, including accuracy, completeness, timeliness, and legibility, as mandated by relevant healthcare regulations and professional standards. When faced with time pressures, nurses should identify critical data points that must be documented immediately to ensure patient safety (e.g., medication administration, significant changes in condition). For less time-sensitive but still important information, a brief note or reminder to complete the charting as soon as possible after the immediate patient care needs are met is advisable. Regular review of institutional policies and regulatory guidelines regarding EHR use and documentation is also essential for maintaining best practices.

The risk matrix shows a patient experiencing unexpected and severe bradycardia during a routine laparoscopic cholecystectomy under general anesthesia. This scenario is professionally challenging due to the immediate threat to patient safety, the need for rapid and accurate assessment, and the potential for rapid deterioration. Effective decision-making requires a systematic approach that prioritizes patient well-being and adheres to established perianesthesia nursing standards and ethical principles. The best approach involves immediate recognition of the critical change in the patient’s physiological status, followed by prompt intervention and communication. This includes alerting the anesthesia provider, initiating the facility’s emergency response protocol, and preparing for potential advanced life support measures. This approach is correct because it directly addresses the immediate life-threatening situation by involving the appropriate clinical team members and activating established emergency procedures, aligning with the perianesthesia nurse’s responsibility to advocate for patient safety and respond effectively to adverse events as outlined in professional nursing standards and facility policies. An incorrect approach would be to delay alerting the anesthesia provider while attempting to independently manage the bradycardia without further assessment or consultation. This is professionally unacceptable as it deviates from the principle of timely communication with the physician responsible for anesthetic management and potentially delays critical interventions, violating the nurse’s duty of care and established protocols for managing intraoperative emergencies. Another incorrect approach would be to focus solely on documenting the event without initiating immediate interventions or alerting the anesthesia provider. This failure to act in a timely manner constitutes a breach of the nursing standard of care and could have severe consequences for the patient, as it prioritizes administrative tasks over immediate patient needs in a critical situation. A further incorrect approach would be to assume the bradycardia is a benign, self-resolving event and continue with the surgical procedure without informing the anesthesia provider. This demonstrates a critical lapse in clinical judgment and a failure to recognize the potential severity of the physiological change, directly contravening the nurse’s responsibility to monitor the patient’s condition and report significant findings. Professionals should utilize a structured decision-making framework such as the Situation, Background, Assessment, Recommendation (SBAR) communication tool, coupled with a rapid assessment of the patient’s ABCs (Airway, Breathing, Circulation) and vital signs. This framework ensures that critical information is communicated clearly and concisely to the appropriate personnel, facilitating prompt and effective management of emergent situations.

This scenario presents a professionally challenging situation due to the inherent complexity of perianesthesia care, where rapid physiological changes can occur, and the nurse must integrate advanced pathophysiology knowledge with immediate clinical actions. The challenge lies in discerning the subtle yet critical signs of a potentially life-threatening complication from expected postoperative sequelae, requiring a high degree of critical thinking and timely, evidence-based intervention. The patient’s history of reactive airway disease adds a layer of complexity, necessitating a heightened awareness of potential respiratory compromise. The best approach involves a systematic assessment that prioritizes immediate physiological stability while concurrently gathering further diagnostic information. This approach is correct because it aligns with the fundamental principles of perianesthesia nursing practice, emphasizing patient safety and the nurse’s responsibility to recognize and respond to deviations from the norm. Specifically, it adheres to the ethical imperative of beneficence by acting in the patient’s best interest and non-maleficence by avoiding unnecessary interventions while diligently investigating potential harm. Regulatory frameworks governing nursing practice, such as those established by the American Nurses Association (ANA) Standards of Professional Practice, mandate that nurses utilize critical thinking and evidence-based practice to make informed decisions, which includes a thorough assessment and appropriate diagnostic workup when a patient’s condition is concerning. This approach ensures that interventions are not only timely but also targeted and effective, minimizing patient risk and optimizing outcomes. An incorrect approach would be to attribute the patient’s symptoms solely to expected postoperative pain and administer only analgesia without further investigation. This is professionally unacceptable because it fails to acknowledge the potential for a more serious underlying pathology, such as bronchospasm or pulmonary edema, which could be exacerbated by delayed diagnosis and treatment. Such an approach violates the ethical principle of non-maleficence by potentially allowing a harmful condition to progress untreated. It also falls short of professional nursing standards that require nurses to perform comprehensive assessments and escalate care when indicated. Another incorrect approach would be to immediately initiate aggressive interventions for a severe complication, such as administering high-flow oxygen and bronchodilators without a clear diagnostic rationale or further assessment. While acting decisively is important, premature or unconfirmed interventions can lead to unnecessary patient distress, potential adverse effects from medications, and can obscure the true diagnosis. This approach risks violating the principle of non-maleficence by potentially causing harm through unindicated treatment and may not be the most efficient or effective use of resources. It also deviates from evidence-based practice, which advocates for a diagnostic process to guide therapeutic decisions. A third incorrect approach would be to delay reporting the patient’s symptoms to the anesthesia provider or surgeon, waiting for the symptoms to worsen significantly. This is professionally unacceptable as it represents a failure to communicate critical patient information in a timely manner, potentially delaying essential medical evaluation and intervention. This delay directly compromises patient safety and violates the ethical duty of advocacy, where nurses are expected to be the patient’s voice and ensure their needs are met promptly. It also contravenes regulatory requirements for clear and timely communication within the healthcare team. The professional decision-making process for similar situations should involve a structured approach: 1) Recognize the deviation from the expected postoperative course. 2) Perform a focused, systematic assessment, prioritizing airway, breathing, circulation, and neurological status. 3) Consider the patient’s underlying pathophysiology and risk factors. 4) Formulate differential diagnoses based on the assessment findings and patient history. 5) Initiate appropriate diagnostic measures to confirm or rule out potential diagnoses. 6) Consult with the anesthesia provider or surgeon promptly with clear, concise data. 7) Implement evidence-based interventions based on confirmed diagnoses and collaborate with the healthcare team.