During the first 24 hours after a kidney transplant, which nursing assessment should be considered priority?

• A. Vital signs.
• B. Urine output hourly using an urimeter.
• C. Incision redness measurement.
• D. Pain assessment.

Answer: (A)

In the first 24 hours after a kidney transplant, the priority is monitoring vital signs to catch instability or complications early. This period carries risks of bleeding, infection, rejection, and fluctuations in graft perfusion, so a frequent pulse, blood pressure, temperature, and respirations readout provides the most immediate picture of how the patient is doing. Abnormal vital signs can signal serious problems requiring rapid intervention, such as hypotension from bleeding, fever from infection or rejection, tachycardia from pain or sepsis, or hypertension from fluid overload affecting graft perfusion. While watching urine output is important for assessing how well the transplanted kidney is functioning, it does not replace the need to assess the patient’s overall physiologic status right away. Once stability is established, you can focus more on graft-specific indicators like hourly urine output, incision healing, and pain management, but the first priority is ensuring the patient’s vital signs are stable.