A child with a forearm fracture has been placed in a tight plaster cast. The child now reports increasing pain despite analgesia, and the fingers are pale, cold, and difficult to move. Which action should the nurse take first?
Correct answer: A. Report possible neurovascular compromise urgently and elevate the limb
- A. Report possible neurovascular compromise urgently and elevate the limb
- B. Apply a warmer blanket and reassess the fingers after four hours
- C. Encourage active finger exercises against the painful cast
- D. Give another analgesic dose and document the finding routinely
Explanation
Increasing pain with pallor, coldness, and reduced movement suggests impaired circulation or compartment syndrome, which threatens the limb. This requires urgent escalation and neurovascular review, not delayed reassessment or treatment with analgesia alone.
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Paediatric emergencies cover rapid assessment using airway, breathing and circulation, basic life support, respiratory distress, choking, shock, seizures, poisoning, burns, severe dehydration and trauma. Questions focus on recognising danger signs, prioritising immediate nursing actions, calculating weight-based treatment and distinguishing compensated from decompensated shock.
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