The nurse is caring for a renal transplant recipient in the postanesthesia care unit. Handoff communication from the OR included a reported output of 500 mL following anastomosis of the renal vessels and reperfusion

Question

One hour after the transplant recipient was admitted to the PACU, the RN notes no urine output. Which physician order should the nurse implement first? a. Administer 20 mg furosemide intravenous (IV) every 4 hours as needed for urine output < 30 mL/hr.
b. Administer a 500-mL bolus of 0.9% normal saline intravenously over 2 hours.
c. Irrigate the indwelling urinary catheter gently with 30 mL 0.9% normal saline.
d. Provide maintenance IV fluids of D5 NS to infuse at 100 mL/hr.

Answer 1

C
Surgical complications following renal transplantation include ureteral obstruction. The nurse should gently irrigate the Foley catheter to determine patency. Furosemide administration should not occur until catheter obstruction has been ruled out. Administration of a fluid bolus should not occur until catheter obstruction has been ruled out. Maintenance fluids administration should be a part of the plan of care but is not the priority in this scenario.