The nurse is caring for a patient with a closed ulna fracture after the application of a cast. After the patient complains of severe pain, the nurse administers an analgesic and applies an ice pack. When the patient states that the medication provided no relief, the nurse should be alert to the possibility of:


• Fracture pain is usually relieved by analgesics, elevation, cold packs, and rest. Pain that is not improved from these interventions is most likely due to impaired perfusion and ischemia. The nurse should assess for vascular compromise and then notify the physician immediately.

• Anxiety often increases pain, but failure to relieve pain from normal interventions is suspicious of vascular compromise.

• Infection and its accompaning pain do not develop immediately.

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