A patient develops a high fever and difficulty breathing shortly after surgery. What should be the immediate concern of the nurse?

Postoperative complications involving respiratory compromise, systemic inflammation, infectious processes, and ventilation-perfusion mismatch occur due to atelectasis, aspiration, pneumonia, or sepsis leading to impaired oxygenation, increased metabolic demand, and thermoregulatory disruption in early surgical recovery phase. Rationale: A. Postoperative fever with respiratory distress indicates pulmonary complication or infection development. Surgical patients are highly susceptible to atelectasis, pneumonia, or sepsis early. Fever reflects systemic inflammatory response with impaired gas exchange. Dyspnea suggests respiratory compromise requiring urgent evaluation and intervention. B. Gastrointestinal obstruction presents with abdominal distension, vomiting, and absent bowel sounds. It does not typically cause acute respiratory distress or high fever. Postoperative respiratory symptoms are unrelated to GI pathology in early immediate phase. Therefore this is not priority concern. C. Postoperative anxiety may cause tachypnea but does not produce high fever. Anxiety-related symptoms are psychological without systemic inflammatory response or infection markers. Fever indicates organic pathology rather than emotional distress. Respiratory difficulty requires exclusion of physical complications first. D. Deep vein thrombosis presents with unilateral leg swelling, pain, and warmth. It may lead to pulmonary embolism but does not directly present as fever and respiratory distress initially. Symptoms described are more consistent with pulmonary or infectious postoperative complications.