The client with rheumatoid arthritis is having her rheumatoid factor (RF) drawn while she is having a flareup of the disease. Which result is seen in clients with rheumatoid arthritis?

Choice A reason: Calling the provider is not the intervention that the nurse should perform first, because it is not the most urgent and relevant action. Calling the provider is a communication intervention, not a respiratory intervention. Calling the provider is an important action, but it should be done after raising the head of the bed, and with accurate and complete information.

Choice B reason: Placing the client in the lithotomy position is not the intervention that the nurse should perform first, because it is not the most urgent and relevant action. Placing the client in the lithotomy position is a positioning intervention, not a respiratory intervention. Placing the client in the lithotomy position is a specific action that is used for pelvic examinations or procedures, not for improving oxygenation.

Choice C reason: Raising the head of the bed is the intervention that the nurse should perform first, because it is the most urgent and relevant action. Raising the head of the bed is a respiratory intervention, not a communication, positioning, or analgesic intervention. Raising the head of the bed is a simple and effective action that can improve the client's breathing, oxygenation, and comfort.

Choice D reason: Obtaining pain medication is not the intervention that the nurse should perform first, because it is not the most urgent and relevant action. Obtaining pain medication is an analgesic intervention, not a respiratory intervention. Obtaining pain medication is an important action, but it should be done after raising the head of the bed, and with a medical order and a proper route.

Choice A reason: Properly disposing of contaminated equipment is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Contaminated equipment, such as gloves, gowns, masks, or needles, should be disposed of in designated containers or bags to prevent exposure or injury to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice B reason: Discarding used syringes into appropriate containers is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Used syringes, especially those that contain blood or body fluids, should be discarded into punctureresistant, leakproof, and labeled containers to prevent needlestick injuries or exposure to others. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice C reason: Changing soiled linens is an important infectioncontrol measure, but it is not the most effective way to prevent the spread of pathogens during client care. Soiled linens, especially those that contain blood or body fluids, should be changed and handled with gloves and minimal agitation to prevent contamination or aerosolization of pathogens. However, this measure does not eliminate the risk of transmission of pathogens from the hands of the health care worker to the client or the environment.

Choice D reason: Performing hand hygiene is the most effective way to prevent the spread of pathogens during client care, because it reduces the number of microorganisms on the hands of the health care worker, which are the most common source and mode of transmission of infection. Hand hygiene should be performed before and after contact with the client, after contact with potentially infectious materials, after removing gloves, and before and after performing invasive procedures. Hand hygiene can be performed by washing with soap and water or using alcoholbased hand rubs.