The nurse is assessing a client who had a fractured femur repaired with an external fixator device. Which assessment finding(s) would cause the nurse concern regarding the development of compartmental syndrome?
1. Decrease in pulse rate in leg
2. Paresthesia distal to area of injury
3. Toes on affected leg cool to touch and edematous
4. Complaints that pins are hurting
5. Complaints of leg pain unrelieved by analgesics or repositioning
6. Client angry and calling loudly to the nurse every 10 minutes
Answers: 2, 3, 5
Paresthesia, edema, and leg pain unrelieved by analgesics are classic indicators of the development of compartmental syndrome. With a femur fracture, there is some degree of edema postoperatively that may leave the toes on the affected leg cool to touch. The decrease in pulse rate is not an indication of pressure, a decrease in pulse strength is. The pins usually do not cause undue pain, and frequently, the client is angry regarding the immobility and does not use effective coping measures. (Lewis 8 ed, p. 1603).