After assessing a client who had surgery a few hours ago, the nurse immediately calls the health care provider. Which assessment findings prompted the nurse to make the urgent call? Select all that apply

Postoperative nursing assessment focuses on early detection of complications such as hemorrhage, infection, and internal organ injury. Sudden changes in vital signs, escalating pain, and abdominal rigidity can indicate serious intra-abdominal complications like bleeding or peritonitis. Rapid recognition and escalation to the health care provider are essential to prevent shock and organ failure. The nurse must prioritize findings that suggest acute deterioration rather than expected postoperative changes. Rationale: A. Absent bowel sounds in all quadrants may occur temporarily after surgery due to anesthesia and decreased gastrointestinal motility. This is commonly expected in the early postoperative period, especially within the first several hours. It should be monitored, but it does not require immediate provider notification unless accompanied by other signs of deterioration. B. A decrease in oxygen saturation from 98% to 95% is a mild change and may still be within acceptable postoperative limits. This slight reduction can occur due to pain, sedation, or shallow breathing after surgery. It warrants monitoring and possibly supportive measures but is not an urgent critical finding on its own. C. Abdominal tenderness and rigidity is an urgent finding because it may indicate internal bleeding, peritonitis, or organ perforation. Rigid abdomen suggests involuntary guarding due to irritation of the peritoneum, which is a surgical emergency. Immediate provider notification is required for further evaluation and intervention. D. A drop in blood pressure from 118/68 to 98/56 mmHg suggests possible hypovolemia or internal hemorrhage. In the postoperative setting, this can indicate bleeding or fluid shifts that compromise perfusion. This change requires urgent evaluation because it may progress to shock if not treated promptly. E. Reporting pain rated as 10/10 in the abdomen, especially if it is a new or sudden escalation, is a significant finding that demands urgent attention. Postoperative pain is expected, but “worst-ever" pain can be a primary symptom of a surgical complication, such as a ruptured suture line or a sudden ischemic event. The nurse must notify the provider to determine if the pain indicates life-threatening abdominal process.