A maintenance worker is found down in a rooftop mechanical room during a heat advisory. Coworkers report he had been working alone for several hours and was found confused and stumbling before he collapsed. On arrival the nurse notes his skin is hot and dry, temperature is 40.6C (105F), and he is not responding to verbal stimuli. Which finding should the nurse expect to distinguish heat stroke from heat exhaustion in this client?
- Mild thirst with a temperature of 38.3C (101F)
- Altered mental status with hot, dry skin
- Muscle cramping in the calves with intact cognition
- Profuse diaphoresis with normal orientation