The nurse reviews a caregiver's message about a child 6 days after a tonsillectomy. Which findings require immediate follow-up? Highlight the findings in the nurses' notes.

Nurses' Notes 0730: The caregiver sends a portal message about a 7-year-old child who is 6 days postoperative after a tonsillectomy. The procedure was performed for recurrent throat infections. The caregiver notes a white-gray coating over the tonsillar beds. The child has strong mouth odor despite gentle oral care. The caregiver reports the child swallows repeatedly even while asleep. The caregiver states that the child spit bright-red blood into a tissue twice this morning. The caregiver reports pain that radiates toward both ears when the child swallows. The child's oral temperature is 37.7 °C (99.9 °F). The caregiver reports no liquids since last evening and no urination for 10 hours. The caregiver administered acetaminophen for pain rated 6/10 that improved to 2/10 after the medication. The child ate cool applesauce without vomiting yesterday afternoon. The caregiver states that the child is difficult to awaken and answers with one-word responses. The child is breathing without stridor. The caregiver reports no rash, facial swelling, or neck stiffness. Another adult is available to drive to the emergency department.