A patient is 6 hours postoperative after abdominal surgery and complains of severe pain despite receiving prescribed pain medication. What should be the nurse's next course of action?

A. Document the patient's pain and notify the physician: While documentation and communication are necessary, the nurse must first gather objective assessment data to provide a meaningful report. Notifying the provider without a physical assessment prevents the identification of acute surgical complications. Physical assessment must always precede notification in the nursing process. B. Encourage the patient to use non-pharmacologic methods like relaxation: While relaxation is a helpful adjunct, it is insufficient as a primary intervention for "severe" acute postoperative pain. Using only non-pharmacologic methods ignores the potential for serious surgical complications that require medical attention. This approach delays necessary diagnostic evaluation of the patient's distress. C. Administer a stronger dose of pain medication: Administering more analgesia without an assessment is dangerous and could mask the symptoms of a worsening condition like hemorrhage or dehiscence. It violates safe practice standards by treating a symptom without investigating the underlying cause. Nurses cannot independently increase doses beyond prescribed limits. D. Perform a focused assessment of the surgical site and evaluate for any complications: Severe pain that is refractory to standard analgesics can be an early warning sign of hematoma, infection, or internal injury. The nurse must inspect the dressing, check for distension, and monitor vital signs to rule out emergencies. Assessment is the critical first step in clinical decision-making.