An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast
At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority?
A) Notifying the doctor immediately
B) Applying ice
C) Elevating the arm
D) Giving additional pain medication as ordered
Ans: A
The nurse should notify the doctor immediately because the girl's symptoms are the classic sign of compartment syndrome. Immediate treatment is required to prevent excessive swelling and to detect neurovascular compromise as quickly as possible. The ice should be removed and the arm brought below the level of the heart to facilitate whatever circulation is present. Giving additional pain medication will not help in this situation.
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