A 4-year-old child with a long leg cast complains of "fire" in his cast. The nurse should:
a. notify the physician on his next rounds.
b. chart the complaint in the nurse's notes.
c. notify the physician immediately.
d. report the complaint to the next nurse on duty.
C
A burning sensation under the cast is an indication of tissue ischemia. It may be an early indication of serious neurovascular compromise, such as compartment syndrome, that requires immediate attention. The child's presenting symptom requires immediate attention. Notifying the physician on the next rounds is inappropriate. Charting the complaint in the nurse's notes is an inappropriate action. Careful notation of symptoms is important, but the priority action is to contact the physician. Communication across shifts is important to the continuing assessment of the child; however, this symptom requires immediate evaluation, and the physician should be contacted.
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