A nurse is caring for a client who is 4 hours postoperative following a transurethral resection of the prostate (TURP). Which of the following is the priority finding for the nurse to report to the provider?

Choice A rationale Following a transurethral resection of the prostate, the presence of thick, bright red-colored urine with clots indicates active arterial bleeding. This is a priority because it can lead to hemorrhage or bladder neck obstruction if the catheter becomes blocked. Normal postoperative drainage should be light pink or amber. Thick red drainage suggests the irrigation rate is insufficient or a surgical vessel has opened, necessitating immediate provider notification to prevent hypovolemic shock or bladder rupture. Choice B rationale A pain level of 4 on a 10-point scale is expected following a surgical procedure like a TURP. This level of pain is considered moderate and can usually be managed with prescribed analgesics or by checking the patency of the urinary catheter, as bladder spasms often cause discomfort. While the nurse must address the pain, it is not a life-threatening finding and does not take priority over the signs of active, heavy hemorrhage in a postoperative client. Choice C rationale An emesis of 100 mL is a common side effect of general or spinal anesthesia used during surgery. It can lead to electrolyte imbalances if persistent, but a single small volume of emesis is not immediately life-threatening. The nurse should provide antiemetics and monitor for further nausea. Compared to the risk of uncontrolled arterial bleeding from the prostate bed, this finding is a lower priority and does not require the same level of urgent medical intervention. Choice D rationale An oral temperature of 37.5 degrees C or 99.5 degrees F is a low-grade fever, which is common in the first 24 hours after surgery due to the inflammatory response to tissue trauma. A significant fever indicating infection usually exceeds 38 degrees C or 100.4 degrees F. While the nurse should continue to monitor the client's thermoregulation, this mild elevation is not a priority finding compared to the risk of hemorrhage indicated by thick, red urine.