The nurse assesses a client weighing 110 kg who had a left nephrectomy for stage 5 kidney trauma. Which assessment finding is most concerning?

Rationale: A. A blood pressure of 132/68 is slightly elevated systolic but within an acceptable range postoperatively for most adults. While blood pressure should be monitored, this finding alone is not the most immediately concerning. B. Incisional pain rated 9/10 is significant and should be managed to improve comfort and mobility. However, severe pain is expected after major surgery like nephrectomy, and while it requires intervention, it is not immediately life-threatening. C. Crackles in the bibasilar lungs may indicate atelectasis or early fluid overload. This finding requires monitoring and possibly interventions like incentive spirometry, but it is not as urgent as potential kidney failure or inadequate perfusion. D. Urine output of 50 mL over two hours is concerning. Normal urine output is generally 0.5–1 mL/kg/hr. For a 110 kg client, expected urine output would be at least 55 mL/hr. Oliguria (low urine output) in a post-nephrectomy patient may indicate acute kidney injury, hypovolemia, or obstruction. Since this client has only one remaining kidney, low urine output is a critical sign of potential renal compromise and requires immediate assessment and intervention.