A patient is admitted with acute gouty arthritis. Which medication does the nurse anticipate the health care provider may prescribe to prevent and treat an acute attack of gout?

Choice A reason: Tennis involves high-impact movements, twisting, and sudden directional changes, which stress the lumbar spine and exacerbate low back pain. These actions increase pressure on intervertebral discs and strain paraspinal muscles, risking further injury. For clients with back pain, low-impact exercises are preferred to avoid aggravating the condition.

Choice B reason: Swimming is a low-impact aerobic exercise that strengthens core and back muscles without stressing the spine. Buoyancy in water reduces gravitational load on vertebrae, minimizing disc compression. Freestyle or backstroke promotes spinal alignment and flexibility, making it an ideal recommendation for managing low back pain safely and effectively.

Choice C reason: Rowing involves repetitive forward flexion and rotation, which can strain lumbar muscles and compress spinal discs, worsening low back pain. The seated position and pulling motion increase intradiscal pressure, risking injury. This high-intensity activity is not suitable for clients seeking back pain relief through exercise.

Choice D reason: Canoeing requires prolonged sitting and repetitive twisting, which stress the lower back. The forward paddling motion increases lumbar flexion, straining muscles and discs. This activity is not recommended, as it can exacerbate pain and lacks the supportive, low-impact qualities needed for safe back pain management.

Choice A reason: A swollen calf is more indicative of deep vein thrombosis (DVT), not fat emboli syndrome. DVT results from venous stasis or clotting post-fracture, causing localized swelling, unlike fat emboli, which primarily affect systemic circulation, lungs, and skin with petechiae, requiring distinct diagnostic and treatment approaches to prevent complications like pulmonary embolism.

Choice B reason: Fever can occur in fat emboli syndrome due to systemic inflammation but is nonspecific, as it’s common in infections or post-fracture inflammation. It’s not a hallmark sign compared to petechiae, which are more specific. Including fever risks misdiagnosis, as it lacks the specificity needed for accurate patient education on fat emboli manifestations.

Choice C reason: Petechiae on the chest are a classic sign of fat emboli syndrome, occurring in 50-60% of cases. Fat globules embolize to small cutaneous vessels, causing pinpoint hemorrhages. This specific finding, often with respiratory distress and neurological changes, aids early diagnosis, guiding urgent interventions like oxygenation to prevent life-threatening complications.

Choice D reason: Paresthesia distal to the fracture suggests local nerve compression or injury, not fat emboli syndrome. Fat emboli cause systemic symptoms like pulmonary and cerebral dysfunction, not localized sensory changes. Misattributing paresthesia to fat emboli could delay treatment for nerve-related issues, compromising patient recovery and accurate symptom management.