The nurse is caring for a child with a unilateral long-leg cast applied for the correction of club foot. Which action is most important for the nurse to perform?

A. Palpate femoral pulses: Assessing femoral pulses can indicate overall arterial blood flow to the lower extremity, but distal perfusion in the toes provides a more immediate indicator of potential compartment syndrome or vascular compromise. B. Compare temperature of both legs: Temperature comparison can help identify decreased perfusion or inflammation, but it is less sensitive than assessing capillary refill in detecting early circulatory compromise. C. Examine for spontaneous movement: Movement assessment helps monitor neurologic function, but early signs of impaired circulation may appear before motor deficits. D. Monitor capillary refill of the toes: Capillary refill is the most sensitive and immediate assessment for distal perfusion and early vascular compromise in a casted limb. Prompt detection allows rapid intervention to prevent tissue ischemia and complications such as compartment syndrome.