A 19-year-old girl sustained multiple long bone fractures as a result of a motor vehicle crash and now is at risk for fat embolism. Which of the following signs and symptoms strongly suggest fat embolism?

Choice A reason: Bradypnea and bradycardia are not typical for fat embolism; the hallmark is respiratory distress with tachypnea and hypoxemia. Choice B reason: Confusion may occur, but bradycardia and bradypnea are inconsistent with fat embolism syndrome. Choice C reason: Tachypnea and tachycardia reflect the respiratory compromise and systemic inflammatory response. Restlessness is due to hypoxia, and petechial rash is a classic manifestation, often appearing on the upper body, conjunctiva, or axilla. This combination is highly suggestive of fat embolism syndrome. Choice D reason: Decreased temperature is not characteristic; patients typically have normal or slightly elevated temperatures. While tachypnea, tachycardia, and petechiae are correct, the inclusion of hypothermia makes this choice inaccurate.