What intervention should the nurse identify as a priority for a client with a nursing diagnosis of ineffective airway clearance related to HIV related pneumonia?

Choice A rationale:
Urine collection from an indwelling catheter is a sterile procedure that requires aseptic technique to prevent contamination of the specimen and potential urinary tract infection. Assistive personnel (AP) may not have the necessary training in sterile technique and therefore should not be delegated this task. Additionally, the nurse needs to assess the patient for any signs of urinary tract infection or other complications before collecting the urine specimen, which is within the scope of nursing practice.

Choice B rationale:
Blood collection for PaCO2 (partial pressure of carbon dioxide) is an invasive procedure that requires assessment of the patient's condition, appropriate site selection, and proper technique to ensure accurate results. This task is within the scope of nursing practice and should not be delegated to AP.

Choice C rationale:
Wound drainage collection for culture also requires aseptic technique to prevent contamination of the specimen and ensure accurate results. The nurse needs to assess the wound for signs of infection, choose the appropriate collection method, and ensure proper labeling and transport of the specimen. This task is within the scope of nursing practice and should not be delegated to AP.

Choice D rationale:
Random stool specimen collection is a non-invasive procedure that does not require sterile technique. AP can be trained to collect random stool specimens safely and effectively, following standard precautions for handling body fluids.

Cardiovascular disease (CVD) is a significant risk factor for gout. This is because CVD often coexists with other conditions that can elevate uric acid levels, such as hypertension, obesity, and chronic kidney disease. Additionally, some medications used to treat CVD, such as thiazide diuretics, can also increase uric acid levels.

Research has shown that people with CVD have a 2-3 times higher risk of developing gout compared to those without CVD.

The mechanisms linking CVD and gout are complex and not fully understood, but they likely involve shared pathways of inflammation and endothelial dysfunction.

Choice D rationale:

Diuretic use, particularly thiazide diuretics, is a well-established risk factor for gout. These medications work by increasing the excretion of fluids and electrolytes from the body, which can also lead to a decrease in the excretion of uric acid.

This can result in a buildup of uric acid in the blood, which can then crystallize in joints and cause gout attacks.

The risk of gout associated with diuretic use is dose-dependent, meaning that higher doses of diuretics are associated with a higher risk of gout.

Choice A rationale:

Depression has not been consistently shown to be an independent risk factor for gout.
Some studies have suggested a possible link between depression and gout, but others have not found any association. More research is needed to clarify the relationship between these two conditions.

Choice B rationale:

Deep sleep deprivation has not been studied as a risk factor for gout.
There is currently no evidence to suggest that it is directly associated with an increased risk of developing the disease.