A nurse is caring for a client on a medical surgical unit. Exhibits Which client findings should the nurse report to the provider immediately? (Select all that apply.)

Rationale: Chest tube output: A sudden stop in chest tube drainage following bright red output earlier can indicate tube obstruction or clot formation. This is concerning post-lobectomy, as blocked drainage may lead to tension pneumothorax or fluid accumulation. Respiratory rate: A rate of 18/min is within normal limits and shows no signs of distress or compromise. Therefore, it does not require immediate reporting. Trachea position: A shift from midline to deviated trachea suggests mediastinal shift, potentially due to a developing tension pneumothorax. This is a medical emergency and must be reported immediately. Urine output: A urine output of 110 mL over one hour is well within normal limits and indicates adequate kidney perfusion. The expected minimum is 30 mL/hr, so this value does not raise concern for hypoperfusion or renal impairment. There is no need to report this finding to the provider at this time. O₂ saturation: A drop from 92% to 89% on room air is clinically significant, especially after thoracic surgery. Hypoxia in this context may signal impaired lung function or emerging complications like pneumothorax. Blood pressure: The client’s blood pressure dropped from 130/80 mm Hg to 110/60 mm Hg within one hour. While 110/60 mm Hg is still within normal range, the sudden 20 mm Hg drop in systolic pressure may indicate early hemodynamic instability, especially postoperatively. Heart rate: A heart rate of 70/min is normal and stable, showing no signs of bradycardia or tachycardia that would warrant concern at this stage. Temperature: A decrease in temperature from 37.2°C to 36.4°C is not clinically alarming postoperatively and does not suggest infection or hypothermia. No need for immediate reporting.