A 40-year-old patient has been admitted to the critical care unit after sustaining multiple injuries from a cave-in accident this morning. X-ray films confirm multiple fractures, including the left femur. During the afternoon, he was taken to surgery for internal fixation of the left femur. It is now 10 pm, and the patient is complaining of severe throbbing pain in his thigh. The patient received 5 mg of morphine sulfate IV 30 minutes ago. The anterior left thigh is firm to touch, and the pain increases when the patient flexes his left leg. The nurse should suspect which of the following?

A. Normal pain related to fractured femur
B. Abnormal pain related to compartment syndrome
C. Abnormal pain related to infection
D. Abnormal pain related to lumbosacral plexus injury

The nurse should suspect abnormal pain related to compartment syndrome based on the patient's severe, persistent pain, firm anterior thigh, and increased pain on leg flexion, despite having received pain medication.

Explanation:

In this scenario, it appears the nurse should suspect abnormal pain related to compartment syndrome. Compartment syndrome is a potentially serious condition that occurs when excessive pressure builds up inside an enclosed muscle space in the body. It is most commonly caused by swelling or bleeding after an injury. The severity of the pain, exacerbated by movement or flexion, the recent surgery, and the firmness of the anterior thigh are classic signs indicating compartment syndrome. Extreme, persistent pain, despite pain relief like morphine, could also suggest compartment syndrome. If suspected, it is considered a medical emergency and immediate attention is required.

Learn more about Compartment Syndrome here:

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