QLexNursing

🟧 The client’s oxygen saturation dropped from 95% to 90%, which is a clinically significant decline and can indicate early postoperative hypoxemia or developing respiratory compromise.

🟧 Low oxygen saturation always takes priority because oxygenation is essential for tissue perfusion, especially in a post-operative client with recent major blood loss.

🟧 The client’s behavioral change—agitation and stating “I feel like something is wrong”—is an early sign of hypoxia and should not be dismissed.

🟧 Behavioral changes often precede vital sign deterioration and may reflect inadequate oxygen delivery to the brain.

🟧 Combining the drop in oxygen saturation with behavioral changes suggests an acute physiologic issue that requires immediate nursing intervention, such as increasing oxygen, performing airway assessment, and notifying the provider.

pain

🟧 Pain rating of 5/10 is expected postoperatively and does not explain the agitation or oxygenation decline.

🟧 Pain is not the priority over respiratory compromise.

WBC count

🟧 WBC is only slightly elevated and does not require immediate follow-up in the acute postoperative period.

🟧 It does not explain the sudden behavioral changes.

bowel findings

🟧 Hypoactive bowel sounds are expected after abdominal surgery.

🟧 This is not an emergent finding.