A 6-year-old involved in a bicycle crash has a right tibia and fibula fracture that has been casted. Which of the following are early signs of compartment syndrome in this child?
Select all that apply.
edema
numbness
severe pain
macular rash
Correct Answer : A,B,C
Rationale:
A. Edema (swelling) within the confined space of the cast is an early sign of compartment syndrome and can compromise circulation.
B. Numbness or tingling (paresthesia) is an early neurovascular sign indicating compromised nerve function.
C. Severe, unrelenting pain, especially pain not relieved by analgesics or pain with passive movement, is one of the earliest and most reliable signs of compartment syndrome.
D. A macular rash is not related to compartment syndrome and is not part of its clinical presentation.
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Related Questions
Correct Answer is C
Explanation
Rationale:
A. Hemoglobin A1c of 5.5% is within the normal range and does not indicate chronic hyperglycemia or diabetic ketoacidosis (DKA).
B. A fasting blood glucose of 124 mg/dL is elevated but not high enough to indicate DKA, which usually involves glucose levels >250 mg/dL.
C. A serum pH of 7.24 indicates metabolic acidosis, a hallmark of diabetic ketoacidosis. This acidic state results from the buildup of ketones due to insulin deficiency.
D. Potassium may initially be elevated in DKA due to acidosis, but a value of 3.9 mEq/L is within normal limits and not specific to DKA.
Correct Answer is B
Explanation
Rationale:
A. Administering more pain medication without assessing the cause of unrelieved pain could mask serious complications, such as compartment syndrome.
B. A circulation (neurovascular) assessment should be the first action to rule out complications such as impaired circulation or compartment syndrome, which can cause unrelieved or worsening pain even after analgesia.
C. The surgeon should be notified after an assessment has been completed and abnormal findings are confirmed.
D. Changing position might help with general discomfort but is not the priority when pain persists after opioid administration, which could indicate a serious issue.
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