The nurse is caring for a client with a fracture of the right humerus. Which assessment finding could be an early sign of a fat embolus?

Choice A reason: Atopic dermatitis is not a likely explanation for the assessment findings, as it is a chronic inflammatory skin condition that causes itching, scaling, and dryness of the skin, usually on the face, neck, and flexural areas.

Choice B reason: Cellulitis is a possible explanation for the assessment findings, as it is a bacterial infection of the skin and subcutaneous tissues that causes warmth, redness, swelling, and pain of the affected area. However, it is not the most likely explanation, as it usually occurs as a result of a break in the skin, such as a wound, insect bite, or ulcer, which is not mentioned in the scenario.

Choice C reason: Seborrheic keratosis is not a relevant explanation for the assessment findings, as it is a benign skin growth that causes brown, black, or tan lesions that have a waxy or scaly appearance, usually on the face, chest, or back.

Choice D reason: Pemphigus is not a plausible explanation for the assessment findings, as it is a rare autoimmune disorder that causes blisters and erosions of the skin and mucous membranes, usually on the trunk, scalp, or mouth.

Choice E reason: Lymphedema is the most likely explanation for the assessment findings, as it is a condition that causes swelling of the arm due to impaired lymphatic drainage after mastectomy surgery. It can also cause warmth, redness, and tenderness of the affected limb.

Choice A reason: Removing the drain is not an appropriate action for the nurse to take, as it may cause bleeding, infection, or hematoma at the surgical site. The drain is placed to prevent the accumulation of fluid and blood in the hip joint, and it should be removed only by the surgeon when the drainage is minimal and the wound is healing.

Choice B reason: Continuing to assess and monitor intake and output every shift is an appropriate action for the nurse to take, as it helps to evaluate the fluid balance and the renal function of the client. The nurse should record the amount, color, and consistency of the drainage, and compare it with the previous measurements. The nurse should also monitor the vital signs, the hemoglobin and hematocrit levels, and the signs of dehydration or fluid overload.

Choice C reason: Elevating the affected leg and placing the client in Trendelenburg position is not an appropriate action for the nurse to take, as it may cause hip dislocation, hypotension, or respiratory distress. The nurse should keep the affected leg slightly abducted and aligned with the body, and avoid flexing the hip more than 90 degrees. The nurse should also maintain the client in a semi-Fowler's or supine position, and avoid turning the client to the affected side.

Choice D reason: Notifying the surgeon and making aware of this finding is not an appropriate action for the nurse to take, as it is not an urgent or abnormal situation. The nurse should report the drainage to the surgeon only if it exceeds the expected amount, which is usually less than 200 mL in the first 24 hours after surgery, or if it changes in color, consistency, or odor.

Choice E reason: None of the above is not a correct choice, as there is one option that matches the most appropriate action for the nurse to take.