A nurse is monitoring a client's lower extremity following the placement of a cast earlier in the day. Which of the following findings should the nurse identify as manifestations of compartment syndrome? (Select all that apply.)

Compartment syndrome is a serious complication that can occur after cast placement, fractures, or trauma when increased pressure within a closed muscle compartment impairs circulation and nerve function. Reduced blood flow leads to tissue ischemia, nerve damage, and possible permanent loss of function if not treated quickly. Early recognition is essential because it is considered an orthopedic emergency. Nurses assess for neurovascular compromise using key findings such as pain, pallor, paresthesia, pulselessness, paralysis, and delayed capillary refill. Rationale: A. Decreased skin turgor is a sign more commonly associated with dehydration rather than compartment syndrome. It reflects fluid volume deficit and does not indicate impaired circulation within an extremity. Neurovascular findings such as pain, pallor, and paresthesia are more specific indicators of compartment syndrome. B. Pain relieved by analgesia is not expected in compartment syndrome because the pain is typically severe, persistent, and often unrelieved by standard pain medication. Pain that is disproportionate to the injury and worsens with passive movement is a classic early sign. Relief with analgesics would make compartment syndrome less likely. C. Sensation of tingling is an important manifestation of compartment syndrome and reflects paresthesia caused by nerve compression and decreased perfusion. As pressure increases within the compartment, nerve function becomes impaired, leading to numbness, tingling, or burning sensations. This is an early warning sign that requires immediate attention. D. Pale-colored toes indicate pallor caused by decreased arterial blood flow to the distal extremity. When compartment pressure rises, circulation becomes compromised and the skin may appear pale, cool, or cyanotic. This finding suggests reduced perfusion and is a significant sign of compartment syndrome. E. Diminished capillary refill is a sign of impaired peripheral circulation and occurs when blood flow to the distal tissues is reduced. Delayed refill indicates vascular compromise and supports concern for compartment syndrome. This finding requires urgent assessment to prevent permanent tissue damage and loss of limb function.