A nurse is caring for a client who is 3 hr postoperative following abdominal surgery.
Which of the following assessment data should the nurse report to the provider?
A.
Serosanguineous drainage noted on the abdominal dressing.
B.
Postoperative laboratory results are Hgb 15% and Hct 40%.
C.
The client’s urine output has been 50 mL since surgery.
D.
The client’s pain level has decreased since the administration of morphine.
The Correct Answer and Explanation is:
The correct answer is C. The client’s urine output has been 50 mL since surgery.
Explanation:
After abdominal surgery, monitoring urine output is a critical aspect of postoperative care because it reflects the client’s kidney function and overall fluid balance. A urine output of less than 30 mL per hour is a concerning indicator of possible renal impairment, hypovolemia (low blood volume), or inadequate perfusion to the kidneys. In this case, the client’s urine output of 50 mL over 3 hours is far below the expected minimum of 90 mL (30 mL per hour), which should be reported immediately to the provider for further evaluation and intervention.
Decreased urine output can be caused by various factors such as dehydration, blood loss during surgery, hypotension, or kidney injury. If left unaddressed, it can progress to acute kidney injury, which may require prompt interventions like fluid resuscitation, medication adjustments, or even more aggressive treatments like dialysis in severe cases.
Now, let’s look at the other options:
- A. Serosanguineous drainage noted on the abdominal dressing: Serosanguineous drainage, which is a mix of blood and serous fluid, is typical in the early postoperative period. It does not necessarily indicate a complication unless it becomes excessive, bright red, or purulent, which would suggest infection or hemorrhage.
- B. Postoperative laboratory results are Hgb 15% and Hct 40%: These values are within normal ranges (Hgb: 12-16 g/dL for women, 14-18 g/dL for men; Hct: 36%-48% for women, 41%-50% for men), and do not indicate any immediate concern.
- D. The client’s pain level has decreased since the administration of morphine: This indicates effective pain management and is not something to report to the provider unless there are concerns about over-sedation or respiratory depression, which is not mentioned in this scenario.
In summary, the urine output of 50 mL in 3 hours is a critical finding that could suggest potential renal dysfunction or inadequate fluid volume, making it the most important data to report to the provider.