A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is appropriate for treating this change in assessment?

D. Petechiae, which are small red or purple spots caused by bleeding under the skin, are a classic manifestation of fat embolism syndrome. They typically appear on the upper chest, axilla (armpit), and conjunctiva of the eyes. Petechiae result from the occlusion of small blood vessels by fat globules, leading to microvascular bleeding.

A Paresthesia distal to the fracture site is not a typical manifestation of fat embolism syndrome. Instead, paresthesia may suggest nerve compression or injury related to the fracture itself rather than fat emboli.

B Fever is not a specific manifestation of fat embolism syndrome. While fever can occur with various types of infections or inflammatory conditions, it is not a hallmark symptom of fat embolism.

C Swelling of the calf can occur with conditions such as deep vein thrombosis (DVT), which is a potential complication of lower limb fractures. However, it is not a typical manifestation of fat embolism syndrome.

A. The heart rate has increased from 92/min on Day 1 to 108/min on Day 2. This significant increase warrants immediate follow-up as it may indicate pain, anxiety, or an underlying physiological issue such as hemorrhage, infection, or cardiac complications.

D. The temperature has increased from 36.4°C (97.5°F) on Day 1 to 37.2°C (98.9°F) on Day 2. While this increase is within a relatively normal range, it is approaching a fever range (> 38°C or 100.4°F) and warrants further evaluation to determine if there is an underlying infection or inflammation.

B. The oxygen saturation remains relatively stable, from 95% on Day 1 to 96% on Day 2. While it is important to monitor oxygen saturation, the minimal change does not indicate an immediate concern. However, it should still be monitored closely for any further decrease.

C. Edema is not directly mentioned in the provided data. While edema can be indicative of various health issues, there is no evidence in the given information to suggest its presence or severity as a concern requiring immediate follow-up.

E. Urine color is not provided in the given data. While changes in urine color can indicate dehydration or other health issues, it is not mentioned in the assessment findings and therefore not a factor for immediate follow-up based on the information provided.

F Pedal pulses were noted as +2 on Day 1, indicating that they were present and normal. Unless there is a significant change in pedal pulses or signs of vascular compromise, such as decreased or absent pulses, there is no immediate need for follow-up based on the given information.