A nurse is teaching a client who has a pelvic fracture about the manifestations of fat embolism syndrome. The nurse should include which of the following findings as an early manifestation?

Choice A reason:
Bradycardia, which is a slower than normal heart rate, is not typically associated with diabetes insipidus. Diabetes insipidus primarily affects the kidneys and fluid balance in the body, leading to frequent urination and thirst but not directly affecting heart rate.

Choice B reason:
Moist mucous membranes are not expected in diabetes insipidus. In fact, due to excessive urination, a person with diabetes insipidus is more likely to experience dry mucous membranes from dehydration unless they are adequately hydrating.

Choice C reason:
Urine specific gravity 1.002 is a key finding in diabetes insipidus. This condition is characterized by the excretion of large amounts of dilute urine with low specific gravity. Normal urine specific gravity ranges from 1.005 to 1.030⁴. A value of 1.002 indicates very dilute urine, which is consistent with the inability of the kidneys to concentrate urine in diabetes insipidus.

Choice D reason:
Bounding peripheral pulses are not a finding associated with diabetes insipidus. Bounding pulses may be associated with other conditions such as fever, anemia, or hyperthyroidism but not typically with diabetes insipidus.

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.