A nurse is evaluating a child during a well exam. The nurse discovers that one leg is shorter than the other. Which is most likely the cause of the difference in leg length?

A. While altered mental status can occur in older adults with pneumonia, especially due to hypoxia or infection, it is often a result of more advanced disease or complications rather than an early symptom. Dehydration can also occur but is not a direct symptom of pneumonia.
B. Hemoptysis (coughing up blood) is not a common early symptom of pneumonia, especially in older adults. Dyspnea (difficulty breathing) may occur, but it generally arises as the pneumonia worsens. These symptoms might not be the first to present.
C. Pleuritic chest pain (pain upon breathing) can be associated with pneumonia but is not necessarily an early symptom, especially in the elderly. Hypertension may be present but is not a hallmark of pneumonia and can vary widely among patients.
D. Fever and chills are common initial symptoms of pneumonia and are part of the body’s response to infection. In elderly patients, fever may sometimes be less pronounced or atypical, but it is still one of the first signs of pneumonia.

A. Cyanosis is a late sign of hypoxia, occurring when oxygen saturation is significantly low. It's often visible in the mucous membranes and skin.
B. Restlessness is often one of the earliest signs of hypoxia. As oxygen levels decrease, the brain becomes deprived of oxygen, leading to changes in mental status, including restlessness, confusion, and agitation.
C. Increased respirations (tachypnea) can be a sign of hypoxia, but it's often a later response as the body attempts to compensate for decreased oxygen levels.
D. Hypertension is not a typical sign of hypoxia. In fact, severe hypoxia can lead to hypotension as blood pressure decreases.