A patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider?

A. Draw blood urea nitrogen (BUN) and creatinine in 2 hours: Monitoring BUN and creatinine is important in patients with polycystic kidney disease, but drawing labs immediately postoperatively is generally not urgent unless there are signs of acute kidney injury. B. Give ketorolac 10 mg PO PRN for pain: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that can reduce kidney perfusion and worsen renal function, particularly in patients with preexisting kidney disease such as polycystic kidney disease. Discussing this order with the healthcare provider is essential to prevent potential nephrotoxicity. C. Infuse 5% dextrose in normal saline at 75 mL/hr: Administering IV fluids is common postoperatively to maintain hydration. This order is generally safe and supports perfusion unless the patient has fluid restrictions or heart failure. D. Order regular diet after patient is awake and alert: Advancing the diet once the patient is awake and alert is routine and generally safe. It does not pose an immediate risk to kidney function.