Which option represents a proper treatment for an unstable patient with an incarcerated hernia showing signs of ischemia?

For an unstable patient with an incarcerated hernia that is exhibiting signs of ischemia, surgical reduction is the appropriate treatment. This condition indicates that the blood supply to the incarcerated tissue is compromised, which can lead to necrosis if not addressed promptly.

Surgical intervention is necessary not only to relieve the incarceration but also to assess the viability of the affected tissue. If the ischemic tissue is found to be necrotic, resection may be required. The urgency of the scenario dictates that immediate surgical evaluation and intervention are crucial in preventing further complications such as perforation or systemic infection.

Other treatments, such as observation, manual reduction, or merely administering medication, would not adequately address the critical nature of ischemia, where delay could lead to significant morbidity or mortality for the patient. Therefore, surgical reduction is the most effective and life-saving approach in this situation.