A postoperative patient has hypotension with cool, clammy skin. Which action is most appropriate first?

• A. Increase the rate of IV fluids.
• B. Notify the ACP immediately.
• C. Administer oxygen at 100%.
• D. Monitor vital signs every 30 minutes.

Answer: (B)

Recognize that hypotension with cool, clammy skin after surgery signals poor perfusion and possible hemorrhage or major fluid loss. The priority is to involve the anesthesia care provider immediately so they can quickly assess the patient and direct the next steps. The ACP can determine the cause—bleeding, third-space losses, or residual anesthesia effects—and order the appropriate interventions right away, such as rapid IV fluid resuscitation, blood products, or vasopressors, and decide if surgical intervention is needed. Providing oxygen and continuing close vital-sign monitoring are important, but they should happen under the ACP’s guidance after the urgent assessment. If the ACP isn’t immediately available, summon additional help promptly to ensure rapid evaluation and treatment.