A nurse is collecting data from a client who has a long-leg cast on his left leg and reports severe pain. Which of the following findings should the nurse identity as an indication that the client might have compartment syndrome? (Select all that apply.)
Explanation & Rationale
A. Ecchymosis in the exposed portion of the left foot: Bruising may occur with the initial injury or minor trauma but is not a reliable early indicator of compartment syndrome. Ecchymosis does not reflect the elevated pressure within the fascial compartment that compromises circulation and nerve function. B. Inability to move the left foot: Motor deficits, such as inability to move the toes or foot, indicate nerve compression and ischemia within the compartment. This is a late but critical sign of compartment syndrome, requiring immediate evaluation to prevent permanent damage. C. Paresthesia in the left foot: Tingling, numbness, or “pins and needles” sensation is an early sign of nerve ischemia caused by increased compartment pressure. Paresthesia often precedes motor deficits and is an important symptom for early recognition and intervention. D. Pallor in the exposed portion of the left foot: Pale skin indicates compromised arterial blood flow resulting from elevated intracompartmental pressure. Pallor reflects ischemia and is a classic clinical sign of compartment syndrome requiring urgent intervention. E. Increased warmth of the exposed portion of the left foot: Compartment syndrome usually causes decreased perfusion, leading to cool or cold extremities rather than warmth. Increased warmth is more commonly associated with infection or inflammation, not compartment syndrome.