The nurse is conducting a postoperative assessment of a client on the first day after renal surgery. Which of the following findings would be most important for the nurse to report to the physician?
A. Temperature, 99.8°F
B. Urine output, 20 ml/hour
C. Absence of bowel sounds
D. A 2×2 inch area of serosanguineous drainage on the flank dressing.
Correct Answer: B. Urine output, 20 ml/hour.
The decrease in urinary output may indicate inadequate renal perfusion and should be reported immediately. Urine output of 30 ml/hour or greater is considered acceptable. There is a possibility that the kidney could become damaged during the surgical procedure. Every attempt will be made to minimize this risk.
Option A: A slight elevation in temperature is expected after surgery. An infection can delay the healing process or cause scarring or other problems. If the wound from the surgical incision becomes infected, it will be treated with antibiotics. Antibiotics are powerful medicines that fight bacterial infections.
Option C: Peristalsis returns gradually, usually the second or third day after surgery. Bowel sounds will be absent until then. The surgery involves the same level of risk for the donor as any other major surgery. The majority of complications following surgery are minor and may cause a longer hospitalization.
Option D: A small amount of serosanguineous drainage is to be expected. The client will be encouraged to move around as soon as he can after surgery. This will stimulate blood circulation to help prevent blood clots.
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