Which findings would indicate a change in the client's condition that would relate to a compromised ulnar nerve integrity following a surgical repair of the elbow?

Question

1. Inability to make the "ok" sign by bringing the thumb to the fourth or fifth finger
2. Pain radiating down from the wrist to the middle finger
3. Edema in the forearm that is ranked 3+
4. Notation of slight flexion limitation (less than 15 degrees) during passive ROM

Answer 1

Inability to make the "ok" sign by bringing the thumb to the fourth or fifth finger

Rationale: Compression from bleeding or severe swelling at the ulnar nerve will not allow the finger and thumb to be brought together without severe pain. Numbness in the ring and pinkie fingers is a symptom of compartment syndrome, not a radiating pain from the wrist to the middle finger. A 3+ edema postoperatively in the forearm is a symptom of impaired circulation above the site of the edema, either from a tight dressing or cast; this is not a symptom of a compromised ulnar integrity. Slight flexion limitations are a symptom of musculoskeletal shortening that comes with disuse and are not a symptom related to ulnar integrity changes.