Which assessment finding in a patient with a fractured femur would lead the nurse to suspect a fat embolism?
A) Dyspnea and tachypnea
B) Unrelieved pain in the fractured leg
C) Volkmann contracture
D) Edema of the affected leg
A) Dyspnea and tachypnea
Explanation: A) Fat embolism may occur in conjunction with closed long bone or pelvic fractures. Respiratory consequences are typically the first symptom of fat embolism syndrome to occur. Fat emboli released from the bone marrow enter the bloodstream and become trapped in the pulmonary and dermal capillaries. In severe cases, dyspnea may progress to respiratory failure with tachypnea and hypoxia.
B) This is a finding in compartment syndrome.
C) A Volkmann contracture is a deformity of the wrist, hand, and fingers caused by ischemia to the forearm, usually as a result of compartment syndrome. Ischemia in the forearm causes the nerves and muscles to become scarred and shortened, forcing the joint to be permanently bent.
D) Fat embolism may occur in conjunction with closed long bone or pelvic fractures. Respiratory consequences are typically the first symptom of fat embolism syndrome to occur. Fat emboli released from the bone marrow enter the bloodstream and become trapped in the pulmonary and dermal capillaries. In severe cases, dyspnea may progress to respiratory failure with tachypnea and hypoxia.
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