A client is being treated for bacterial pharyngitis. Which of the following should a nurse recommend when promoting the client's nutrition during treatment?

A. Advocacy: Advocacy involves representing the interests and needs of individual patients or groups within the healthcare system. While the nurse's actions may indirectly benefit patients by improving care standards, the focus here is on systemic changes rather than individual patient representation. Advocacy often involves lobbying for resources, policy changes, or addressing ethical concerns on behalf of patients, which is not the primary goal of the actions taken in this scenario.
B. Quality improvement: This term best describes the nurse's actions as it focuses on enhancing healthcare practices and patient outcomes through systematic efforts. By identifying the increase in pressure injuries and collaborating with management to implement a new policy, the nurse is actively participating in a quality improvement initiative aimed at reducing risks and improving care protocols in the ICU. This approach reflects a commitment to continuous improvement in patient safety and care standards, aligning with best practices in healthcare.
C. Case Management: Case management primarily involves coordinating care for individual patients, ensuring they receive appropriate services, and managing their healthcare journey. While the nurse may address pressure injuries at the unit level, the actions taken are broader and not confined to individual patient care. Case management emphasizes individualized care plans and resource allocation rather than addressing systemic issues affecting a group of patients in the ICU.
D. Collaboration: Collaboration refers to working together with others, such as colleagues and management, to achieve common goals in patient care. While the nurse did collaborate with the manager to develop and implement the new policy, collaboration alone does not capture the proactive approach taken to address the increase in pressure injuries. It emphasizes teamwork but lacks the focus on systematic quality enhancement that characterizes quality improvement efforts, which aim to implement lasting changes in practices and outcomes.

• Respiratory Rate: LTB, Epiglottitis, Foreign Body Aspiration. An increased respiratory rate (tachypnea) is common in both conditions due to airway obstruction and respiratory distress. In epiglottitis, inflammation and swelling of the epiglottis severely restrict airflow, leading to tachypnea. Similarly, foreign body aspiration can cause partial obstruction, increasing respiratory effort and rate. Increased respiratory rate is a significant finding in LTB due to airway narrowing and respiratory distress. The body compensates for the partial airway obstruction by increasing ventilation. However, tachypnea in LTB is usually not as severe as in epiglottitis or foreign body aspiration, where airway obstruction is more critical.
• Irritability: LTB, Epiglottitis, Foreign Body Aspiration. Irritability is a common symptom in all three conditions due to hypoxia and respiratory distress. In LTB (croup), inflammation leads to airway narrowing, causing discomfort and restlessness. In epiglottitis, the rapid onset of airway swelling results in agitation. Foreign body aspiration also causes significant distress due to the sudden obstruction of airflow.
• Drooling: Epiglottitis, Foreign Body Aspiration. Drooling is characteristic of epiglottitis because the client cannot swallow due to severe throat pain and airway swelling. It is also seen in foreign body aspiration when an object is lodged in the airway or esophagus, making swallowing difficult. Drooling is not a typical feature of LTB, where coughing and stridor are more prominent.
• Fever: LTB, Epiglottitis. Both LTB and epiglottitis are caused by infections and present with fever. In LTB, viral infections like parainfluenza commonly cause a low-to-moderate fever. Epiglottitis, often caused by bacterial infections such as Haemophilus influenzae type B (Hib), typically presents with a high fever, as seen in this case. Foreign body aspiration is not associated with fever unless secondary infection develops.
• Immunization Status: Epiglottitis. Epiglottitis is strongly linked to Haemophilus influenzae type B (Hib), a bacteria preventable by routine childhood vaccination. In unvaccinated individuals or those with incomplete immunization, epiglottitis is more likely to occur. Immunization status does not directly correlate with LTB (which is viral) or foreign body aspiration.