A Patient Has Been in Bed Two Days Post Operatively

A patient has been in bed two days post operatively a total knee replacement. He is refusing to get up out of bed because of the pain. The nurse is concerned that he is developing pneumonia. What signs and symptoms should be reported to the doctor to explore the possibility of pneumonia?

A) Change in level of consciousness, increase in irritability and lethargy.
B) Sudden onset of chills with high fever and a headache.
C) Muscle twitching, nausea and vomiting.
D) Diminished or absent breath sounds over the lungs, dullness on percussion.