The patient cannot remember voiding in the last 24 hours after transplant. Which instruction should the nurse give?

• A. Advise the client to come to the clinic right away for further evaluation.
• B. Schedule elective appointment in a week.
• C. Tell the client to rest and drink fluids.
• D. Send to the emergency department.

Answer: (A)

Urgent assessment for a potential urinary complication after a kidney transplant. After transplant, urine production should begin promptly; not voiding for 24 hours can signal urinary retention or an obstruction at the urinary connection, which can jeopardize graft function. The appropriate action is to have the patient come in for evaluation promptly so the team can check catheter patency, perform a bladder scan, review urine output and renal function, and order imaging or studies as needed to identify obstruction or other graft issues. Resting and increasing fluids won’t address a possible obstruction, delaying care could worsen graft function, and sending to the emergency department is more appropriate only if there are immediate, severe symptoms. Getting evaluated right away with the transplant clinic ensures timely assessment and intervention.