It is suspected that the client's oxygenation status is deteriorating. The nurse is aware that which abnormal assessment finding represents the most serious indication of the client's decreased ox-ygenation?
a. Poor skin turgor
b. Clubbing of the nails
c. Central cyanosis
d. Pursed-lip breathing
C
Central cyanosis is the most serious finding because it indicates hypoxemia.
Poor skin turgor indicates dehydration. It is not an indication of the client's decreased oxygena-tion.
Clubbing of the nails is found in clients with prolonged oxygen deficiency, endocarditis, and congenital heart defects. It is a change that occurs over time, and is not an indication of the cli-ent's current deterioration in oxygenation status.
Pursed-lip breathing is used to slow expiratory flow. It is not the most serious indication of a client's decreased oxygenation.
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