A nurse is collecting data from a client who has a long leg cast that was applied 2 days ago. Which of the following findings should the nurse report to the provider?

A long leg cast is used to immobilize fractures and promote bone healing, but it can also lead to complications such as compartment syndrome, impaired circulation, and nerve compression. After cast application, ongoing assessment of neurovascular status is essential to detect early signs of compromised perfusion. Pain that worsens rather than improves is a critical warning sign of potential complications requiring immediate intervention. Nurses must differentiate expected discomfort from abnormal findings that indicate tissue ischemia. Rationale: A. Increasing pain in the affected extremity is a hallmark early sign of compartment syndrome or impaired circulation under the cast. This type of pain is often severe, unrelieved by analgesics, and may worsen with movement. It indicates rising pressure within the muscle compartments that can compromise blood flow and tissue viability, requiring immediate provider notification. B. Itching beneath the cast is a common and expected finding during the healing process. It results from skin dryness and tissue regeneration under immobilization. Although uncomfortable, it does not indicate neurovascular compromise and can be managed with safe comfort measures. C. Warm toes indicate adequate peripheral perfusion and are a normal finding after cast application. This suggests that arterial blood flow to the distal extremity is intact. It is a reassuring sign rather than an abnormal one that requires reporting. D. Capillary refill of 3 seconds is slightly delayed but may still be within acceptable limits depending on baseline and clinical context. However, it is less urgent than escalating pain. It should be monitored closely, but increasing pain is a more critical early indicator of compromised circulation that requires immediate attention.