A nurse is caring for a client.

Exhibits

Which of the following actions should the nurse take? (Select all that apply.)

• 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.

A. Conduct a study about the time and money costs of implementing the change. While analyzing costs and time efficiency is important for evaluating resource utilization, it does not directly measure the effectiveness of the changes in reducing medication errors. The primary goal of quality improvement is to assess patient safety outcomes rather than financial impact alone.
B. Establish a benchmark to identify a standard of performance. Setting benchmarks is a useful strategy for quality control, but it is a preliminary step in the evaluation process. Benchmarks provide a target for improvement, but they do not measure whether the specific changes implemented have led to a reduction in medication errors.
C. Compare the number of medication errors before and after the action was implemented. The most effective way to evaluate the success of the changes is to analyze pre- and post-intervention data. Comparing the frequency of medication errors before and after the quality improvement measures allows for an objective assessment of whether the interventions have led to a meaningful reduction in errors.
D. Provide the staff with a questionnaire to quantify staff satisfaction with the changes. Staff feedback is valuable for assessing workflow and morale, but it does not directly measure the effectiveness of the intervention in reducing medication errors. A reduction in actual error rates provides a more concrete evaluation of the intervention’s success.