Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What constitutes the later signs of acute compartment syndrome in orthopedic surgery?

1. Pain, paresthesia, and pallor

2. Pale, pulselessness, pressure rising, paralysis

3. Swelling, weakness, and speed of movement decrease

4. Increased capillary refill, warmth, and redness

The correct answer is: Pale, pulselessness, pressure rising, paralysis

The later signs of acute compartment syndrome are characterized by pale or pulseless extremities, rising intracompartment pressures, and paralysis. These symptoms indicate that the blood flow and nerve function in the affected compartment are severely compromised, often due to swelling or bleeding within a closed space surrounded by fascia. Paleness and the absence of pulse suggest that the tissue is at risk of ischemia, which can lead to necrosis if not addressed promptly. Rising pressure within the compartment is a critical indicator of the condition, as it can surpass the venous pressure, inhibiting blood flow. Paralysis signifies nerve damage that is frequently irreversible if not treated immediately. Recognizing these severe signs is vital for timely intervention, as acute compartment syndrome can lead to serious complications, including muscle and nerve damage. In contrast, pain, paresthesia, and pallor usually occur in the earlier phases of acute compartment syndrome, while swelling, weakness, and decreased movement reflect initial symptoms rather than the later, more critical manifestations of the condition. Increased capillary refill, warmth, and redness do not align with typical findings of compartment syndrome and may suggest other issues, such as inflammation or infection rather than ischemia.