What symptom should a nurse instruct guardians to report after a toddler has a leg cast applied?

Instructing guardians to report a restricted ability to move the toes is critical after a toddler has a leg cast applied because this symptom could indicate potential complications such as compartment syndrome, which impairs circulation and function of the affected limb. Normal movement of the toes is significant for assessing neuromuscular function after casting. If the toes cannot be moved, it may suggest that the cast is too tight, leading to increased pressure on the surrounding tissues and nerves. Early recognition of this symptom is vital for timely intervention, which can prevent more serious complications, such as irreversible damage to the nerves or blood vessels.

In contrast, capillary refill time less than 2 seconds is typically a sign of good perfusion, indicating that blood flow is adequate. While swelling can occur when the leg is in a dependent position, it is often a temporary response and may not indicate a serious problem unless it becomes progressively worse. Similarly, a bilateral +3 pedal pulse indicates a strong pulse, which doesn't necessarily warrant immediate concern in the absence of other symptoms.