A patient with a femur fracture develops shortness of breath and petechiae on the face. The nurse should be concerned about which condition?

• A. DVT
• B. Fat embolism
• C. PE
• D. Stroke

Answer: (B)

A femur fracture can release fat droplets from bone marrow into the bloodstream. These fat emboli can travel to the lungs, causing respiratory symptoms like shortness of breath and hypoxemia, and they can also produce a characteristic petechial rash on the face and upper body. This combination after a long-bone fracture—rapid breathing difficulty along with facial petechiae—is classic for fat embolism syndrome.

DVT would present more with leg swelling and tenderness, not facial petechiae, and while a DVT can lead to a pulmonary embolism, the facial rash isn’t typical. A pulmonary embolism itself causes sudden shortness of breath and chest pain but usually lacks the facial petechiae seen with fat embolism. A stroke would present with focal neurological deficits rather than respiratory distress and a facial rash.