A client has a leg cast following an open reduction for a fractured tibia. Approximately two hours after returning to the unit, the client reports severe pain in the affected extremity, and the nurse observes that the limb is blue and blanched. Which action should the nurse perform first?

Choice A reason: Documenting and monitoring are important, but delaying intervention in the presence of signs of compartment syndrome can lead to irreversible damage. Choice B reason: Releasing traction without provider direction may be unsafe and is not the nurse’s first independent action. Choice C reason: Notifying the healthcare provider immediately is critical. Severe pain, discoloration, and blanching suggest compromised circulation, possibly compartment syndrome, which requires urgent evaluation and intervention. Choice D reason: Administering pain medication may mask symptoms and delay necessary treatment. Pain unrelieved by medication is a red flag for ischemia.