A nurse on a pediatric unit is caring for a preschooler who is postoperative following an appendectomy. Complete the following sentence by using the lists of options. The child is at risk for developing dropdown as evidenced by their dropdown and dropdown

Rationale for correct choices: Pneumonia: The child is at high risk for postoperative pneumonia due to decreased lung expansion and secretion retention. This is supported by increasing respiratory rate, diminished breath sounds at the bases, and refusal to participate in lung expansion therapy. Shallow breathing: Pain and opioid use (morphine) contribute to shallow respirations, which reduce alveolar ventilation and promote atelectasis, a precursor to pneumonia. Lack of incentive spirometer use: Incentive spirometry helps prevent atelectasis by promoting deep breathing. The child’s refusal significantly increases the risk for lung collapse and subsequent pneumonia. Rationale for incorrect choices: Peritonitis: Although abdominal tenderness is increasing, there is no fever, guarding, rigidity, or signs of systemic infection indicating peritonitis at this time. Wound infection: The surgical dressing is dry and intact, and there are no signs of redness, drainage, or significant fever to suggest infection. Bowel sounds: Absent bowel sounds are expected early postoperatively and do not directly indicate the highest risk complication here. Temperature: The temperature is slightly elevated but not high enough to indicate infection; low-grade fever is common postoperatively. Abdominal tenderness: Expected after surgery and not specific for pneumonia risk. Surgical dressing: Intact with no signs of infection, so not a contributing factor.