Trauma Nurse Core Course (TNCC) Practice Exam

What condition is commonly associated with respiratory distress and petechiae in a patient with multiple rib and femur fractures?

1. Acute lung injury

2. Fat embolism

3. Pneumothorax

4. Pulmonary contusion

The correct answer is: Fat embolism

The condition commonly associated with respiratory distress and petechiae in a patient who has sustained multiple rib and femur fractures is fat embolism. After significant trauma, particularly with long bone fractures such as femur fractures, fat globules can be released from the bone marrow into the systemic circulation. This leads to a range of clinical manifestations, including the classic triad of respiratory distress, petechial rash, and neurological symptoms. In the case of respiratory distress, fat globules can occlude pulmonary capillaries, causing impaired gas exchange and leading to hypoxemia. The petechiae often appear around the conjunctiva, axilla, and neck due to small vessel occlusion by fat globules. Recognizing fat embolism is crucial because it can rapidly progress to serious complications, such as acute respiratory distress syndrome (ARDS). Conditions like acute lung injury, pneumothorax, and pulmonary contusion might present with respiratory distress too, but they do not typically cause petechiae, which is a hallmark of fat embolism in the context of trauma associated with long bone fractures. Thus, understanding the context and clinical signs assists in identifying fat embolism as the correct answer in this scenario.