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: Fasciotomy is the primary surgical treatment for compartment syndrome, where increased intracompartmental pressure threatens muscle and nerve viability. Incising the fascia relieves pressure, restoring perfusion and preventing necrosis. Prompt preparation for fasciotomy is critical to salvage tissue, avoiding permanent damage or amputation in acute cases from trauma or fractures.

Choice B reason: Internal fixation, used for fracture stabilization, does not address compartment syndrome’s urgent pressure buildup. While fractures may contribute to the condition, fasciotomy is prioritized to relieve pressure. Expecting fixation misguides preparation, risking delayed decompression, which could lead to muscle necrosis, nerve damage, or limb loss.

Choice C reason: Tendon release is not a treatment for compartment syndrome, which involves fascial compartment pressure, not tendon pathology. Fasciotomy targets fascia to relieve pressure. Assuming tendon release misdirects surgical preparation, delaying critical intervention and increasing risks of irreversible tissue damage, chronic pain, or functional loss.

Choice D reason: Amputation is a last resort for compartment syndrome, used only if fasciotomy fails or necrosis is irreversible. Preparing for amputation first overlooks fasciotomy’s potential to save the limb. This assumption risks unnecessary limb loss, misaligning with urgent decompression to restore perfusion and preserve function in acute cases.

Choice A reason: Aspirin, a nonsteroidal anti-inflammatory drug, inhibits prostaglandin synthesis, reducing gastric mucosal protection and increasing ulcer risk. In a client with a history of gastric ulcers, aspirin can exacerbate or reactivate ulcers, leading to bleeding or perforation. This is a contraindication, especially in rheumatoid arthritis patients requiring long-term pain management.

Choice B reason: Glaucoma is not a contraindication for aspirin. Aspirin does not affect intraocular pressure or optic nerve function in glaucoma. Its anti-inflammatory and analgesic effects are safe for pain relief in rheumatoid arthritis, making this an incorrect choice for a contraindication in this context.

Choice C reason: Recent migraine headaches are not a contraindication for aspirin, which is often used to treat migraines due to its analgesic and anti-inflammatory properties. Aspirin may even benefit headache relief in rheumatoid arthritis patients, making this an incorrect choice for a contraindication to its use.

Choice D reason: Amenorrhea, or absence of menstruation, is unrelated to aspirin’s mechanism or side effects. Aspirin’s gastrointestinal, renal, or hematologic risks do not interact with menstrual history. This finding is irrelevant to aspirin safety in rheumatoid arthritis, making it an incorrect contraindication.