If a child’s capillary refill time distal to a cast is noted as 4 seconds, what should the nurse's next action be?

When a child’s capillary refill time distal to a cast is noted to be 4 seconds, this suggests a potential issue with circulation, indicating that the cast may be too tight or that there could be an underlying complication, such as compartment syndrome. A normal capillary refill time is typically less than 2 seconds, so a reading of 4 seconds is concerning and requires prompt attention.

Contacting the healthcare provider is the most appropriate action in this situation because it allows for a timely assessment and intervention. The healthcare provider may need to evaluate the child further, potentially arrange for the cast to be loosened or removed, or initiate other treatments to address any complications that may be occurring due to compromised circulation. This urgent communication ensures that the child's well-being is prioritized and the necessary medical interventions can be implemented without delay.