A nurse is caring for a school-age child who has a new plaster cast to stabilize a fracture of the radius. Which of the following actions should the nurse take to prevent the development of compartment syndrome in the affected extremity?

Compartment syndrome is a serious complication that can occur after fractures and casting due to increased pressure within a closed muscle compartment. This increased pressure can impair circulation, leading to tissue ischemia and potential permanent nerve and muscle damage if not promptly addressed. Early prevention and monitoring are critical in clients with newly applied casts such as a plaster cast for a radius fracture. Nursing interventions focus on maintaining adequate perfusion and identifying early signs of neurovascular compromise. Rationale: A. Applying hot air from a blow dryer to the cast is contraindicated because heat can increase tissue swelling within the confined space under the cast. Increased swelling further elevates intracompartmental pressure, worsening the risk of compartment syndrome. Additionally, heat may damage the integrity of the plaster cast material. B. Instructing the child to avoid moving the fingers is incorrect because active finger movement promotes circulation and helps prevent stiffness and venous stasis. Restricting movement can worsen swelling and reduce distal perfusion. Encouraging gentle finger movement is an important preventive measure for maintaining neurovascular function. C. Placing the affected extremity in an elevated position above the heart is appropriate because it helps reduce swelling and promotes venous return. Decreasing edema within the casted limb lowers intracompartmental pressure and improves circulation. This intervention is a key preventive strategy for reducing the risk of compartment syndrome. D. Monitoring capillary refill of the child’s fingers is essential but should be performed more frequently than once or at unspecified long intervals. Delayed or infrequent assessment may result in missed early signs of ischemia. However, monitoring alone does not prevent compartment syndrome; it is a diagnostic measure rather than a preventive intervention.