Nurse Cirie is caring for a client who suffered a smoke inhalation injury. The carbon monoxide report reveals a level of 35%. Based on the level, which of the following signs should the nurse expect in the client?
A. Seizure
B. Confusion
C. Flushing
D. Coma
Correct Answer: B. Confusion
Signs and symptoms of carbon monoxide levels between 21-40% (moderate poisoning) include hypotension, tachycardia, headache, drowsiness, confusion, nausea, and vomiting. Mental status changes such as altered level of consciousness, disorientation, and memory loss may occur.
Option A: Carbon monoxide levels of 41% to 60% result in seizures. As carboxyhemoglobin (COHgb) levels rise, the cerebral blood vessels dilate, and both coronary blood flow and capillary density increase. If exposure continues, central respiratory depression develops which may result from cerebral hypoxia.
Option C: Carbon monoxide levels of 11% to 20% result in flushing. The classic symptoms of cherry red nail beds and mucous membranes are not “classic” and are usually post-mortem findings. Patients may also develop ataxia, apraxia, incontinence, and cortical blindness.
Option D: Cardiac effects, especially ventricular arrhythmias occur. Ventricular arrhythmias are implicated as the cause of death most often in CO poisoning. There is evidence that myocardial impairment begins at the relatively low level of COHgb of 20%.
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