Following hip replacement surgery, a 92-year-old patient with pneumonia shows which finding would be most concerning to the practical nurse?

Following hip replacement surgery, a 92-year-old patient with pneumonia shows which finding would be most concerning to the practical nurse?

• A. Respiratory rate of 20 breaths per minute
• B. Productive cough
• C. Restlessness
• D. Arterial pO2 of 90 mm Hg

Answer: (C)

Recognizing early signs of respiratory compromise in an elderly postoperative patient with pneumonia. Restlessness is most concerning because it can be the first clue of hypoxemia or inadequate oxygen delivery to the brain. In older adults, changes in mental status or agitation often precede obvious breathing difficulty, so restlessness may indicate that oxygenation or ventilation is deteriorating even if other signs seem normal. A normal respiratory rate and an arterial pO2 of 90 mm Hg do not rule out problems in this context, and a productive cough is a common feature of pneumonia rather than a warning sign of acute deterioration. Together, these factors make restlessness the most urgent finding to assess further—check oxygen saturation, reassess respiratory status, and act promptly if hypoxia is suspected.

Recognizing early signs of respiratory compromise in an elderly postoperative patient with pneumonia. Restlessness is most concerning because it can be the first clue of hypoxemia or inadequate oxygen delivery to the brain. In older adults, changes in mental status or agitation often precede obvious breathing difficulty, so restlessness may indicate that oxygenation or ventilation is deteriorating even if other signs seem normal.

A normal respiratory rate and an arterial pO2 of 90 mm Hg do not rule out problems in this context, and a productive cough is a common feature of pneumonia rather than a warning sign of acute deterioration. Together, these factors make restlessness the most urgent finding to assess further—check oxygen saturation, reassess respiratory status, and act promptly if hypoxia is suspected.