A nurse is caring for a middle adult client who has just received the diagnosis of endometrial cancer. In taking a nursing history, which of the following manifestations is likely to be reported by this client?

Choice A reason:

Pneumothorax, a collapsed lung, can indeed cause shortness of breath and dyspnea. However, it is typically associated with a sudden onset of these symptoms following a chest injury or spontaneously in the case of a ruptured air blister. In the context of a femoral head fracture, pneumothorax is less likely unless there was additional trauma to the chest area.

Choice B reason:

Pneumonia is an infection of the lungs that leads to inflammation of the air sacs, causing them to fill with fluid or pus. Symptoms include cough with phlegm, fever, chills, and difficulty breathing. While pneumonia could cause dyspnea, it usually develops due to an infectious process rather than directly from a femoral head fracture.

Choice C reason:

Airway obstruction involves a blockage that prevents air from passing freely to the lungs. It can be caused by foreign objects, swelling due to allergic reactions, or other medical conditions. The symptoms of airway obstruction include difficulty breathing, wheezing, and potential changes in skin color. However, airway obstruction is not commonly a direct complication of a femoral head fracture.

Choice D reason:

Fat embolism syndrome is a serious condition that occurs when fat globules enter the bloodstream and lodge within the pulmonary vasculature, leading to respiratory distress. It is a known complication following long bone fractures, such as the femur, and presents with symptoms like shortness of breath, hypoxemia, and neurological manifestations. Given the recent femoral head fracture and the symptoms reported, fat embolism syndrome is the most likely diagnosis.

Choice A reason:
Weight loss is a common finding in individuals with uncontrolled type 1 diabetes mellitus. Due to the lack of insulin, the body cannot utilize glucose effectively, leading to the breakdown of body fat and muscle for energy, resulting in weight loss.

Choice B reason:
Hematuria, or blood in the urine, is not a typical finding associated with uncontrolled type 1 diabetes mellitus. While diabetes can cause kidney damage over time, leading to proteinuria, hematuria would not be an expected finding solely due to uncontrolled diabetes.

Choice C reason:
Bradycardia, or a slower than normal heart rate, is not a common finding in uncontrolled type 1 diabetes mellitus. In fact, diabetes can sometimes cause autonomic neuropathy, which can affect the heart rate, but this typically does not result in bradycardia.

Choice D reason:
Hypertension is more commonly associated with type 2 diabetes mellitus, often due to insulin resistance. In type 1 diabetes, especially when uncontrolled, hypertension is not a typical finding unless there is coexisting kidney damage.