During fat embolism management, the patient becomes cyanotic with decreasing SaO2. What is the priority nursing action?

• A. Position the client on her right side with her head down
• B. Prepare the client for a blood transfusion
• C. Initiate cardiopulmonary resuscitation
• D. Ensure that intubation equipment is readily available

Answer: (D)

When fat embolism affects the lungs, oxygenation can deteriorate rapidly. If the patient becomes cyanotic with a falling SaO2, the immediate concern is securing and protecting the airway to ensure adequate ventilation. Having intubation equipment readily available allows rapid airway management and initiation of assisted ventilation if respiratory failure develops, which can prevent progression to respiratory arrest. Other actions aren’t as urgent in this moment: repositioning the patient doesn’t reliably improve oxygenation and can complicate care; a blood transfusion isn’t an acute, universal fix for fat embolism; CPR is only indicated if there is cardiac arrest. The priority is to be prepared to secure the airway and support breathing to maintain oxygenation.