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Problem
A 40-year old man presents complaining of an area of redness and tenderness on his left forearm that started 2 days ago. He does not recall being bitten by any insect. However, he does report working in his attic the last few days cleaning out some old boxes. The patient reports that the area of redness is growing and now has a black ulcer in the center and is about the size of a dime in diameter. Patient denies any shortness of breath, weakness, ecchymosis, or fever/chills. Patient last received a tetanus booster 8 years ago. The NP suspects a spider bite. What is/are the next most appropriate action(s) for the NP to take in caring for this patient?
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