A nurse is caring for a client who has a hip and pelvis fracture. On Day 1 at 1100, the nurse documents the following: Client admitted from the emergency department after falling at home. Client reports pain 7/10 in right hip and lower back. Alert and oriented to person, place, and time Bilateral breath sounds are clear Pedal pulses +2: skin is pink and warm to touch movement and sensation intact to extremities Reddened and ecchymotic areas noted on the middle to Slight edema to sacral and lilac region present Temp 97.5 F. HR 92. RR 22. BP 146/05. O2 Sat 95% On Day 2 at 0945, the nurse documents the following: Client unable to void and bladder is distended. Indwelling urinary catheter inserted; draining dark, reddish colored urine; Edema to sacral and iliac region 2+. Lower extremities cool to touch, pedal pulses absent bilaterally, capillary refill time >6 seconds. Temp 98.9 F, HR 108, RR 24, BP 154/78, 02 Sat 96% pain reported at 10/10. Based on the day 2 assessment the nurse is concerned that the patient may be developing:

A. Compartment syndrome: The client exhibits hallmark signs of compartment syndrome, including severe pain (10/10), cool lower extremities, absent pedal pulses, delayed capillary refill, and increasing edema. These indicate compromised circulation and tissue perfusion, which is a surgical emergency to prevent permanent nerve and muscle damage. B. Fat emboli: Fat embolism syndrome typically presents with respiratory distress, hypoxia, petechial rash, and neurological changes, usually 24–72 hours after a long bone fracture. While the client has a fracture, there are no respiratory or neurological signs indicative of fat embolism at this time. C. Pulmonary emboli: Pulmonary embolism usually manifests with sudden dyspnea, chest pain, tachypnea, hypoxia, and possibly hemoptysis. The client’s respiratory status is stable with normal O₂ saturation, making PE less likely based on the current assessment. D. Deep vein thrombosis: DVT often presents with unilateral leg swelling, warmth, and tenderness, but the client has bilateral lower extremity coolness, absent pulses, and delayed capillary refill, suggesting arterial compromise rather than venous thrombosis.