Final answer:
The nurse's priority assessment finding for an ALS patient being admitted with pneumonia would be indications of respiratory distress, due to the risk of respiratory failure. If the patient shows any signs of difficulty breathing, this would take precedence over the other listed assessment findings.
Step-by-step explanation:
For a client with amyotrophic lateral sclerosis (ALS) being admitted to the hospital with pneumonia, the nurse's priority assessment finding would be respiratory distress or any sign of respiratory compromise. While all of the assessment findings listed are important, ALS patients experience a degeneration of motor neurons that control voluntary movements, including those necessary for breathing. Option 'a', a respiratory rate of 18/min, seems to be within normal limits, but given the ALS and pneumonia, the nurse must vigilantly monitor for changes. Option 'b', increased creatinine level, and option 'c', distended abdomen, are concerning but not the immediate priority. The weakness in the extremities (option 'd') is a characteristic of ALS but the immediate life-threatening issue in a patient with pneumonia would be the potential for respiratory failure. Symptoms like crackling sounds in the lungs, an elevated heart rate, shortness of breath, and the need for assistance from machines to breathe indicate priority for respiratory assessment in an ALS patient with pneumonia.
Therefore, any signs of deteriorating respiratory function would be the nurse's priority as they assess an ALS patient with pneumonia. The presence of crackling sounds, shortness of breath, or requiring technological support to breathe well are urgent signs that need immediate attention. Priority care would focus on ensuring effective ventilation and oxygenation.