The nurse is monitoring for complications following a scheduled tonsillectomy. What post-op finding is of most concern to the nurse?

A. Reports of pain is incorrect because pain is expected after a tonsillectomy due to tissue trauma and inflammation. It is usually managed with analgesics and, while important to monitor, it is not indicative of an acute, life-threatening complication. B. Mouth breathing is incorrect because postoperative mouth breathing is common due to throat discomfort, nasal congestion, or swelling. It is not considered a warning sign for hemorrhage or other severe complications, though hydration and comfort should still be ensured. C. Dark red scabbing is incorrect because some dark red scabbing is normal at the tonsillectomy site and reflects the healing process. This is typically harmless unless accompanied by active bleeding or systemic signs such as pallor or hypotension. D. Frequent swallowing is correct because frequent swallowing can indicate ongoing or active postoperative bleeding. After a tonsillectomy, hemorrhage is a serious and potentially life-threatening complication, particularly within the first 24 hours or 5–10 days post-op when scabs begin to slough. Signs of hemorrhage include vomiting or spitting up bright red blood, pallor, tachycardia, hypotension, and restlessness. Immediate nursing actions include assessing airway and vital signs, notifying the surgeon, maintaining IV access for fluid resuscitation, and minimizing agitation to reduce further bleeding.