Which of the following mental status changes may occur when a client with pneumonia is first experiencing hypoxia?
A. Coma
B. Apathy
C. Irritability
D. Depression
Correct Answer: C. Irritability
Clients who are experiencing hypoxia characteristically exhibit irritability, restlessness, or anxiety as initial mental status changes. As the hypoxia becomes more pronounced, the client may become confused and combative. Apathy and depression are not symptoms of hypoxia.
Option A: Coma is a late clinical manifestation of hypoxia. Pneumonia is a common cause of mortality and morbidity. It can have a myriad of clinical presentations and can pose a diagnostic dilemma especially in the setting of severely ill patients with several comorbidities and underlying lung pathologies.
Option B: Apathy is not a symptom of pneumonia. Historically, the chief complaints in case of pneumonia include systemic signs like fever with chills, malaise, loss of appetite, and myalgias. These findings are more common in viral pneumonia as compared to bacterial pneumonia. A small fraction of patients may have an altered mental status, abdominal pain, chest pain, and other systemic findings.
Option D: Depression is not a symptom of pneumonia. Pulmonary findings include cough with or without sputum production. Bacterial pneumonia is associated with purulent or rarely blood-tinged sputum. Viral pneumonia is associated with watery or occasionally mucopurulent sputum production.
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