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:
Coughing and deep breathing are essential for mobilizing and removing secretions from the airways, which is crucial for improving airway clearance in patients with pneumonia. These techniques help to loosen mucus and bring it up from the lungs, allowing it to be expelled through coughing.
Hydration maintenance is also critical because it helps to thin secretions, making them easier to cough up. Adequate hydration helps to keep mucus moist and less sticky, which promotes easier expectoration.
Choice B rationale:
Keeping the head of the bed elevated can help to improve oxygenation and reduce the work of breathing, but it does not directly address the issue of airway clearance. It may be a helpful adjunct intervention, but it's not the priority for this specific nursing diagnosis.
Choice C rationale:
Preparation for insertion of a tracheostomy tube is a more invasive intervention that may be necessary in severe cases of airway obstruction, but it is not the first-line intervention for ineffective airway clearance related to pneumonia. It would be considered if other measures fail to maintain adequate ventilation.

Choice D rationale:
Providing supplemental oxygen can help to improve oxygenation in patients with pneumonia, but it does not directly address the issue of airway clearance. It's important to support oxygenation, but it's not the primary intervention to clear secretions.

Choice A rationale:
Pain management: Rheumatoid arthritis (RA) is a chronic inflammatory disease that causes pain, stiffness, swelling, and fatigue in the joints. Pain is often the most debilitating symptom of RA, and it can significantly impact a person's quality of life.

Therefore, the nurse's primary consideration is to ensure the client's comfort by effectively managing their pain. This may involve using a variety of interventions, such as:
Administering pain medications as prescribed Applying heat or cold therapy
Using assistive devices to reduce joint strain
Teaching the client about pain management techniques, such as relaxation exercises and pacing activities
Promoting rest and sleep: Rest and sleep are essential for healing and reducing inflammation. The nurse can encourage the client to rest during the day and to get enough sleep at night.
Creating a comfortable environment: The nurse can help to create a comfortable environment for the client by adjusting the room temperature, providing soft bedding and pillows, and reducing noise and distractions.
Providing emotional support: RA can be a challenging disease to live with, and it can take a toll on a person's emotional well- being. The nurse can provide emotional support by listening to the client's concerns, offering reassurance, and encouraging them to express their feelings.
Choice B rationale:
Motivation is important: While motivation is important for self-management of RA, it is not the primary consideration for the nurse. The nurse's focus is on providing comfort and addressing the client's immediate needs. Once the client's pain and other symptoms are managed, the nurse can then work with the client to develop a plan for managing their RA long-term. This may include providing education about the disease, teaching self-care strategies, and encouraging the client to participate in activities that promote physical and emotional well-being.
Choice C rationale:
Surgery may be an option: Surgery may be an option for some clients with RA, but it is not the primary consideration for the nurse. Surgery is typically considered only after other treatment options have failed to control the client's symptoms.
Choice D rationale:
Education is important: Education is an important part of managing RA, but it is not the primary consideration for the nurse. The nurse's focus is on providing comfort and addressing the client's immediate needs. Once the client's pain and other symptoms are managed, the nurse can then provide education about the disease and its management.