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