A nurse is caring for a client who is found unresponsive and pulseless in their room. An ECG confirms the client is in pulseless ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?

Choice A reason: A high purine diet is a risk factor for gout because purines are metabolized into uric acid, which can accumulate and form crystals in the joints.

Choice B reason: Being well-hydrated is not a risk factor for gout; in fact, adequate hydration helps prevent gout attacks by diluting and promoting the excretion of uric acid.

Choice C reason: Diuretic use can increase the risk of gout by reducing the kidneys' ability to excrete uric acid, leading to higher levels in the blood.

Choice D reason: Starvation dieting can lead to an increase in uric acid production, raising the risk of gout attacks.

Choice E reason: Having a normal BMI is not a risk factor for gout. Obesity is a known risk factor, while maintaining a healthy weight can reduce the risk of developing gout.

Rationale

• B. Sudden pain relief: The intense pain associated with otitis media is caused by the accumulation of fluid and pressure against the tympanic membrane. When the membrane ruptures, that pressure is instantaneously released, resulting in a sudden and dramatic decrease in pain. This is often followed by purulent (pus-filled) or serosanguineous (bloody) drainage in the external ear canal.

Why the others are incorrect

• A. Increased temperature: While a fever is a common sign of an acute infection (Acute Otitis Media), it is not a specific indicator that the eardrum has ruptured. In fact, systemic symptoms like fever may actually decrease once the pressure and infection are vented through a rupture.

• C. Popping sensation when swallowing: This sensation is typically associated with the opening and closing of the Eustachian tube as it attempts to equalize pressure in the middle ear. It is a common symptom of Eustachian tube dysfunction or fluid in the ear, but it indicates an intact eardrum rather than a ruptured one.

• D. Green-blue discharge in the ear canal: While drainage (otorrhea) occurs after a rupture, the color is typically clear, bloody, or yellowish-white (purulent). Green-blue discharge is more characteristic of Pseudomonas infections, often seen in otitis externa (swimmer's ear), rather than a standard tympanic membrane rupture from middle ear effusion.