Following a bowel resection, a client's tympanic temperature was 97.6° F (36.4° C) on admission to the postanesthesia care unit (PACU). Thirty minutes later, the temperature is 101.6°F (38.7°C). Which intervention(s) should the nurse implement? Select all that apply.

A. Continue to monitor vital signs every hour: Simply continuing routine monitoring is not sufficient in response to a sudden and significant temperature spike. A rapid rise in temperature shortly after surgery may indicate malignant hyperthermia or sepsis, both of which require immediate intervention. B. Apply oxygen via nasal prongs at 4 L/minute: Supplemental oxygen is important during a suspected hypermetabolic crisis such as malignant hyperthermia. Increased metabolic activity raises oxygen demand, and oxygen therapy supports tissue perfusion and reduces hypoxia risk. C. Recheck all vital signs including core temperature: A rapid reassessment helps confirm the rise in temperature and detect other abnormalities like tachycardia, hypotension, or increased end-tidal CO₂. Verifying core temperature also helps determine the severity of the response and guides further action. D. Expose client's extremities and apply ice packs to axilla: External cooling may be helpful but should not be done before confirming the diagnosis. It may delay more appropriate measures like administering dantrolene if malignant hyperthermia is suspected, and should only be part of a broader management plan. E. Page the admitting anesthesiologist STAT: A sudden spike in temperature shortly after surgery raises concern for malignant hyperthermia, a rare but life-threatening emergency. Immediate anesthesiologist notification is critical to initiate rapid treatment and administer dantrolene if needed.