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:
Venous thromboembolism (VTE) is a condition where blood clots form in the deep veins, usually in the legs. While VTE is a risk following trauma and immobilization, the acute onset of shortness of breath and chest pain is less typical for VTE, which more commonly presents with leg pain and swelling.

Choice B reason:
Hypovolemic shock occurs due to significant blood or fluid loss, leading to decreased blood volume and inadequate circulation. While it can result from a motor-vehicle crash, the client's symptoms of shortness of breath and chest pain are not the most indicative of hypovolemic shock, which typically presents with rapid pulse, low blood pressure, and cold, clammy skin.

Choice C reason:
Compartment syndrome is a surgical emergency where increased pressure within the muscle compartments impairs circulation and nerve function. It presents with severe pain, swelling, and sometimes paralysis of the affected limb, but it does not typically cause shortness of breath or chest pain.

Choice D reason:
Fat embolism syndrome (FES) is a serious complication that can occur after long bone fractures. Fat globules may enter the bloodstream and travel to the lungs, leading to respiratory distress, which can manifest as shortness of breath and chest pain. FES can also cause neurological symptoms and a petechial rash. Given the client's symptoms and recent trauma, FES is a likely complication and requires immediate assessment and intervention.

Choice A reason:
Antinuclear antibody (ANA) is a test used to help diagnose autoimmune disorders, including RA. However, ANA is not typically used to monitor the effectiveness of treatment with aspirin in RA. Aspirin is an anti-inflammatory medication, and its effectiveness would not be directly measured by changes in ANA levels.

Choice B reason:
Erythrocyte sedimentation rate (ESR) is a blood test that can detect inflammation in the body and is commonly used to assess the severity of inflammation in patients with RA. Aspirin can reduce inflammation, so a decrease in ESR can indicate the effectiveness of aspirin therapy in managing RA symptoms.

Choice C reason:
Rheumatoid factor (RF) is an antibody that can be present in the blood of people with RA. While RF can be used to help diagnose RA, it is not typically used to monitor the effectiveness of aspirin therapy. RF levels can remain elevated even when symptoms are well-controlled.

Choice D reason:
White blood cell (WBC) count is a measure of the body's immune response and can be elevated in cases of infection or inflammation. However, WBC count is not specifically used to monitor the effectiveness of aspirin therapy in RA. Aspirin's primary effect is on reducing inflammation and pain, not necessarily on altering WBC counts.