After becoming incontinent of urine, an older client is admitted to a nursing home. The client's rheumatoid arthritis contributes to severely painful joints. The primary consideration in the care of this client is the need for: 1. Control of pain 2. Immobilization of joints 3. Motivation and teaching 4. Bladder training and control

The primary consideration in the care of this client would be 1. Control of pain. Pain control is critical because it will affect every aspect of the client's care and quality of life. Severe pain can hinder not just physical function but also emotional well-being and the ability to participate in other aspects of care, such as bladder training and mobility exercises. Effectively managing the client's pain through medication, physical therapy, or other interventions provides a foundation that can enable them to engage more meaningfully in their care and potentially improve outcomes in other areas.

Extra: In dealing with rheumatoid arthritis (RA), which is a chronic inflammatory disorder affecting joints and causing them to swell and be painful, it's important to manage pain so the person can maintain as much function as possible. Untreated or poorly managed pain can lead to decreased mobility and a reduced quality of life. Control of pain is also essential because it can help the client stay motivated to perform daily activities and engage in their care plan.

Immobilization of joints might sometimes be necessary, but it is typically not the primary focus, as prolonged immobilization can lead to joint stiffness and muscle wasting.

Regarding the incontinence, while bladder training and control are crucial aspects of care for an incontinent patient, without adequate pain control, it will be difficult for the client to participate successfully in such training. Motivation and teaching are also essential for managing both incontinence and arthritis, helping clients understand their condition and the importance of active participation in their care plan. However, without managing the pain effectively first, it can be challenging to proceed with these aspects of care.