A nurse is caring for a postoperative client. Which of the following findings indicate the client may be actively bleeding?

Rationale A. Restlessness: Restlessness can be an early sign of hypovolemia due to blood loss. Reduced circulating volume leads to decreased oxygen delivery to tissues, including the brain, causing anxiety, agitation, or confusion. Monitoring for restlessness helps identify active bleeding before more overt signs appear. B. Brisk capillary refill: Brisk capillary refill indicates good peripheral perfusion and adequate circulating volume. In the context of active bleeding, capillary refill would more likely be delayed due to hypovolemia. C. Bounding pulses: Bounding pulses are associated with fluid volume excess rather than blood loss. In active bleeding, pulses are more likely to be weak, thready, and rapid as the body attempts to compensate for decreased blood volume. D. Warm skin: Warm, dry skin generally reflects stable perfusion. Active bleeding often causes cool, clammy skin as vasoconstriction occurs to maintain blood flow to vital organs. Skin assessment provides important clues about hemodynamic status.