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0730 assessment note: Amara, a 34-year-old woman, was admitted 48 hours ago following a crush injury to her right lower leg sustained in a workplace accident. Her right leg is in a splint. She rates her pain as 9/10 and describes it as a deep, burning ache that is not relieved by the prescribed analgesics. On exam, the right leg appears tense and shiny. Passive dorsiflexion of the right foot causes her to cry out. Pedal pulse on the right is diminished compared to the left, and capillary refill in the right toes is 4 seconds. Which finding is most indicative that Amara is developing a complication requiring immediate escalation to the primary health care provider?
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