A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following changes in assessment should indicate to the nurse that the client could be developing a serious complication?

A. Increased blood pressure from 112/68 to 120/72 mm Hg is incorrect because this is a minimal, non-significant change and not indicative of a serious complication. B. Increased respiratory rate from 18 to 44/min is correct because a sudden, severe increase in respiratory rate may indicate fat embolism syndrome, a serious complication following long bone fractures such as the femur. C. Increased oral temperature from 36.6° C (97.8° F) to 37° C (98.6° F) is incorrect because this is a normal variation and not concerning. D. Increased heart rate from 68 to 72/min is incorrect because this is a mild increase and not significant enough to suggest a complication.