A nurse is assessing a client who has chronic emphysema. The client is receiving oxygen at 2 L/min via nasal cannula and is resting with the head of bed elevated to a 45° angle. Which of the following findings should the nurse identify as an early indication of hypoxia?

A. Decreased level of consciousness: This is a late sign of hypoxia, indicating significant oxygen deprivation and possible brain involvement. Immediate intervention is required at this stage. B. Restlessness: Restlessness is an early clinical manifestation of hypoxia. It reflects the body’s initial response to inadequate oxygenation, often presenting as anxiety, irritability, or agitation, and should prompt further assessment and intervention. C. Circumoral cyanosis: Cyanosis around the mouth is a late sign of hypoxia, typically appearing after prolonged oxygen deprivation when oxygen saturation has significantly dropped. D. Seizures: Seizures occur only in severe, prolonged hypoxia or hypoxemia affecting the central nervous system. This is a late and serious indicator of oxygen deprivation.