A nurse is caring for a toddler who had a cast applied 2 hr ago due to multiple fractures of the right hand. Which of the following findings should the nurse report immediately to the charge nurse?

The parent reports the child will not keep the arm elevated on the pillow.

The fingers on the right hand have a capillary refill of 4 seconds.

The fingertips of the right hand are swollen and bruised.

The child is not attempting to move her right arm or fingers.