In assessing a comatose client with a fractured femur and pelvis, which early signs of fat embolism should a nurse look for?

In patients who have experienced a fracture, particularly of long bones such as the femur or pelvis, the risk of fat embolism syndrome is a significant concern. The early signs of fat embolism typically manifest within 1 to 3 days post-injury. An important aspect to recognize is the presence of pulmonary symptoms, as fat globules can travel to the lungs and lead to respiratory distress.

Increased heart rate tends to occur as a compensatory response to decreased oxygenation or increased pulmonary vascular resistance, which may occur when fat globules obstruct pulmonary circulation. Adventitious breath sounds, such as crackles or wheezes, may indicate the presence of fluid in the alveoli (pulmonary edema) or airway obstruction due to fat globules affecting gas exchange. These signs point to the respiratory complications associated with fat embolism, making them critical for early identification and management.

The other options, while each symptom can be relevant in various clinical contexts, do not fully capture the unique pulmonary and cardiovascular symptoms that are key indicators of fat embolism syndrome. Increased heart rate and chest tightness may suggest other cardiovascular issues rather than align closely with fat embolism. Shortness of breath and extreme fatigue are generic signs and do not specify respiratory changes. Persistent cough