A 10-year-old male is admitted to the hospital with a fracture of the left femur. The patient is placed in skeletal traction for 2 days. Which of the following would make the nurse immediately suspect peripheral neurovascular impairment?

Pallor, numbness, and absent peripheral pulses


• Assess neurovascular status of the left lower extremity, including temperature, color, pulses, edema, and capillary refill. Compare findings with the unaffected extremity.

• Children in traction need to be assessed carefully for neurovascular impairment, as do children in casts.

• The extremity in traction should be checked every 15 minutes during the first hour, hourly for 24 hours, and every 4 hours thereafter for any signs of pallor, coldness, tingling, absent peripheral pulse, edema, or pain.

Incorrect options:

• Muscle spasms, tenderness, and abnormal mobility are not early manifestations of neurovascular impairment.

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