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: An oblique fracture involves a diagonal break across the bone, typically from twisting forces, not splintering into multiple pieces. Comminuted fractures, as described, involve multiple fragments. Misidentifying as oblique risks inappropriate treatment, like simple casting instead of surgical fixation, delaying healing and increasing nonunion risk in complex tibial fractures.

Choice B reason: An impacted fracture occurs when bone ends are driven together, often in compression injuries, not splintered into pieces. The described tibial fracture with multiple fragments is comminuted. Assuming impacted misguides management, potentially overlooking the need for surgical stabilization, complicating recovery and alignment in severe fractures.

Choice C reason: A comminuted fracture, where the bone splinters into multiple fragments, matches the x-ray description. Common in high-energy trauma like falls, it requires surgical fixation to align fragments and ensure healing. Accurate identification guides appropriate intervention, preventing complications like malunion or infection in complex tibial fractures.

Choice D reason: A transverse fracture is a straight, horizontal break, not involving multiple fragments. The described splintered tibia indicates a comminuted fracture. Misdiagnosing as transverse risks inadequate treatment, like casting instead of surgery, leading to poor alignment, delayed healing, or chronic pain in severe tibial injuries.

Choice A reason: Applying pediculicide lotion is inappropriate for tick removal, as it targets lice, not ticks. This could irritate the skin or prompt the tick to regurgitate, increasing the risk of pathogen transmission, such as Borrelia burgdorferi causing Lyme disease. Proper removal uses mechanical extraction to minimize infection, ensuring safe and effective tick removal without chemical interference.

Choice B reason: Using a hot ember to remove a tick is hazardous and ineffective. Heat may cause the tick to release pathogens into the bite site, heightening infection risk, and can burn the skin. Safe removal involves tweezers grasping the tick near the skin for intact extraction, reducing complications like Lyme disease or Rocky Mountain spotted fever transmission.

Choice C reason: Grasping the tick close to the skin with fine-tipped tweezers is the standard method. This ensures complete removal, including mouthparts, minimizing infection risk from pathogens like Borrelia burgdorferi, which causes Lyme disease. The technique prevents tissue damage and pathogen spread, promoting safe extraction and reducing complications from tick-borne illnesses.

Choice D reason: Using a twisting motion risks breaking the tick’s mouthparts, leaving them embedded, which increases infection risk and complicates removal. A steady, upward pull without twisting is recommended to extract the tick fully, preventing transmission of diseases like Lyme disease or babesiosis, ensuring effective and safe tick removal.