A patient with a femur fracture reports sudden dyspnea and chest pain 8 hours after injury. What should be the nurse's first action?

• A. Provide high flow oxygen
• B. Check for positive Chvostek's sign
• C. IV vasopressor medication
• D. Monitor patient for headache

Answer: (A)

When a patient with a recent femur fracture suddenly develops dyspnea and chest pain, the immediate concern is impaired oxygenation from a potential fat embolism or pulmonary embolism. The first action is to provide high-flow oxygen to rapidly correct hypoxemia and support ventilation while the team assesses the cause and initiates further treatment. This step keeps tissues well-oxygenated and buys time for diagnostic workup (such as imaging) and more definitive management. Other actions don’t address the acute breathing emergency: checking a Chvostek sign relates to calcium status, vasopressors are only first-line if there's hypotension, and simply monitoring for headache doesn’t help with sudden respiratory distress.