Rachel Poole, a 20-year-old woman diagnosed with stage II breast cancer, underwent a bilateral total mastectomy with a free TRAM breast reconstruction. The surgery was completed with no complications. Now that the procedure has been completed, the anesthesia provider extubates Ms. Poole before her transport to the PACU. Upon extubation, her blood pressure drops to 70/30 mmHg, her pulse drops to 45 bpm, her respiratory rate drops to 8/min, and her oxygen saturation drops to 70% on 2 L of oxygen through a nasal cannula. What factors could be contributing to Ms. Poole’s changes in vital signs
