If surgery is needed, which procedure would the nurse first prepare the patient for to treat compartment syndrome?

Choice A reason: Using a blow dryer to dry a fiberglass cast is inappropriate, as casts should be kept dry to prevent skin maceration or infection. Fiberglass is water-resistant but not waterproof, and heat can damage the cast or skin. This instruction risks complications, misguiding patients on proper cast care and hygiene.

Choice B reason: Using a cotton swab under the cast to relieve itching is unsafe, as it may introduce debris or cause skin injury, increasing infection risk. Itching should be managed with elevation or antihistamines. This advice misaligns with cast care, potentially leading to complications like dermatitis or bacterial infection under the cast.

Choice C reason: Avoiding all movement of the affected leg is impractical and harmful. Controlled movement, as advised, prevents stiffness and muscle atrophy while maintaining circulation. Complete immobilization risks complications like contractures. This instruction misguides recovery, delaying rehabilitation and functional restoration in patients with a tibial fracture.

Choice D reason: Reporting worsening or unrelieved pain is critical, as it may indicate complications like compartment syndrome, infection, or cast pressure. Pain assessment ensures timely intervention, preventing serious outcomes like tissue necrosis or delayed healing. This instruction aligns with safe cast care, promoting patient safety and effective fracture management.

Choice A reason: Zolpidem, a sedative-hypnotic, treats insomnia by enhancing GABA activity in the brain. It has no role in gout management, as it does not address uric acid levels, inflammation, or pain associated with gouty arthritis. Administering it would be irrelevant and fail to target the underlying pathophysiology of gout.

Choice B reason: Alprazolam, a benzodiazepine, manages anxiety by depressing central nervous system activity. It does not affect uric acid metabolism or inflammation in gout. Using it for gout is inappropriate, as it lacks anti-inflammatory or urate-lowering properties, offering no therapeutic benefit for the condition.

Choice C reason: Allopurinol is a xanthine oxidase inhibitor that reduces uric acid production, preventing gout attacks. It is a first-line medication for chronic gout management, lowering serum urate levels to prevent crystal formation in joints. The nurse should prepare to administer it to address the client’s hyperuricemia effectively.

Choice D reason: Spironolactone, a potassium-sparing diuretic, treats hypertension and edema by antagonizing aldosterone. It has no direct effect on uric acid levels or gout inflammation. Its use could even increase uric acid reabsorption, potentially worsening gout, making it an inappropriate choice for this client.