Which findings would indicate possible compromise of ulnar nerve integrity following surgical repair of a patient's elbow?
1. Edema in the forearm that is rated 3+
2. Pain radiating from the wrist to the middle finger
3. Inability to make the "OK" sign by bringing the thumb to the fourth or fifth finger
4. Slight flexion limitation (less than 15 degrees) during passive ROM
3
Rationale 1: Edema in the forearm rated at 3+ is a symptom of impaired circulation above the site of the edema, either from a tight dressing or cast; it is not a symptom of compromised ulnar integrity.
Rationale 2: Numbness in the ring and pinkie fingers is a symptom of compartment syndrome that would occur with compromise of the ulnar nerve. Radiating pain from the wrist to the middle finger would not be an expected finding.
Rationale 3: Compression from bleeding or severe swelling at the ulnar nerve would not allow the finger and thumb to be brought together without severe pain.
Rationale 4: Slight flexion limitations are a symptom of musculoskeletal shortening that comes with disuse and are not a symptom related to ulnar integrity changes.
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