A client comes to the clinic with a complaint of pain in the right great toe and is eventually diagnosed with gout. When planning teaching for this client, what management technique should the nurse emphasize?

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.

To calculate the total output for the client, we need to add up all the individual outputs:

• The client voided 400 mL at 1100.
• The client voided 350 mL at 1430.
• The closed chest drainage system increased from 155 mL to 175 mL, which is an increase of 20 mL.
• The NG tube has 575 mL in the drainage container.
• The Jackson-Pratt drainage tube has 25 mL.

Adding all these amounts together, the total output that the nurse should record in the medical record is 1370 mL.

Here’s the calculation:

400 mL + 350 mL + (175 mL - 155 mL) + 575 mL + 25 mL = 1370 mL400mL+350mL+(175mL−155mL)+575mL+25mL=1370mL

So, the nurse should record a total output of 1370 mL in the medical record for the client.