While reviewing the hourly rounding logs on an orthopedic trauma unit, the nurse identifies four clients requiring attention. Which client should the nurse evaluate first?
- A client who underwent a closed reduction of a fractured femur 24 hours ago and is newly exhibiting agitation and a petechial rash on the upper chest.Cevap
- BA client with an open tibial fracture who has a temperature of 101.8°F (38.8°C) and localized erythema around the external fixator pins.
- CA client in skeletal traction for a pelvic fracture who is experiencing severe muscle spasms and rating their pain as a 9 on a 0-to-10 scale.
- DA client recovering from a total hip arthroplasty who has a hemoglobin level of 9.2 g/dL (92 g/L) and reports fatigue when repositioning.
Cevap
The client who underwent a closed reduction of a fractured femur 24 hours ago and is newly exhibiting agitation and a petechial rash on the upper chest.
Fat embolism syndrome (FES) is a life-threatening complication that typically occurs 24 to 72 hours after long bone or pelvic fractures. The classic triad of FES includes respiratory distress (often presenting early as restlessness or agitation due to hypoxemia), neurologic changes, and a characteristic petechial rash on the chest, axillae, or conjunctivae. This client is demonstrating early, acute signs of compromised airway, breathing, and circulation, making them the absolute highest priority for immediate intervention and oxygen therapy.
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Prioritization: Recognizing Fat Embolism Syndrome