The nurse is working on a pulmonary unit at the local hospital. The nu

The nurse is working on a pulmonary unit at the local hospital. The nurse is alert to one of the early signs of hypoxia in the clients, which is:

1. Cyanosis
2. Restlessness
3. A decreased respiratory rate
4. A decreased blood pressure

ANSWER

ANS: 2
Mental status changes are often the first signs of respiratory problems and may include restless-ness and irritability. Cyanosis is a late sign of hypoxia. A decreased respiratory rate is not an early sign of hypoxia. The respiratory rate will increase as the body attempts to compensate for the de-creased level of oxygen. As the hypoxia worsens, the respiratory rate may decline. During early stages of hypoxia the blood pressure is elevated unless the condition is caused by shock.