Final answer:
The nurse practitioner should first recommend using warm compresses twice daily for a 23 year old female patient with 2-3 cm furuncles, as this helps to promote natural drainage and relieve discomfort without the need for more invasive procedures.
Step-by-step explanation:
A 23 year old female patient comes to the clinic with 2-3 cm furuncles in her right axilla area, on right elbow, and right forearm. The furuncles are round, red bumps that are hot and tender to the touch. In the initial management of furuncles, which are deeper skin infections often involving a hair follicle, it is important to promote drainage and relieve discomfort.
Given the description of the furuncles, without any systemic signs of infection such as fever or chills, the nurse practitioner should first recommend using warm compresses twice daily (BID). This approach aids in drawing out the pus and promotes natural drainage without the need for an invasive procedure right away. Although antibiotic treatment may become necessary if the furuncles do not improve or if they worsen, it is not the immediate first step without signs of systemic infection or severe local infection.
Incision and drainage is a more aggressive treatment that can be considered if the furuncles do not respond to conservative measures like warm compresses, or if they become more severe. Ordering a plain radiograph of the elbow is generally not indicated for furuncles unless there is a suspicion of underlying bone involvement (which is rare and associated with more serious conditions).