This patient has signs of internal bleeding Decreased breath sounds--> abdomen filling with fluid, so the diaphragm has to push against increased pressure to get a breath in. Abdominal distension, tachycardic, hypotensive.

hematocrit drop by 12%. think about this. 1% change in hematocrit is 3 units of blood. 1 unit is 500mL. So based on her calculated blood loss, she should have only dropped hct by (1%-2). So I mean it could be underestimated blood loss, but her PE signs point to hemorrage

• Patient’s blood pressure has dropped, pulse has gone up and hematocrit has dropped relative to intraoperative values, pointing to bleeding after surgery