The nurse is caring for a client who has been diagnosed with acute glomerular nephritis, that returned one hour ago from having a kidney biopsy to determine the cause. Which assessment finding requires immediate notification of the health care provider?

Rationale: A. Cola-colored urine is a common finding in acute glomerulonephritis due to hematuria. It occurs because inflammation of the glomeruli allows red blood cells to leak into the urine. Although concerning for disease monitoring, this finding is expected in this condition and is not immediately life-threatening. The nurse should continue to monitor urine output and characteristics but does not need to notify the provider immediately based solely on this symptom. B. Periorbital edema is common in glomerulonephritis due to fluid retention and sodium/water imbalance. While it is important for ongoing monitoring, progressive edema does not constitute an immediate emergency post-biopsy. Fluid management and patient education are key interventions. C. Pain of 6/10 at the biopsy site is anticipated because the procedure involves a percutaneous needle puncture of the kidney. Mild to moderate pain is expected and can usually be managed with prescribed analgesics. Immediate provider notification would be necessary only if the pain suddenly worsens, is accompanied by swelling or bruising, or suggests internal bleeding. D. A blood pressure of 169/91 mmHg indicates significant hypertension in the immediate post-biopsy period. High blood pressure is particularly dangerous after a kidney biopsy because it increases the risk of bleeding from the biopsy site, formation of a perirenal hematoma, and potential acute kidney injury. Hypertension can also worsen existing renal dysfunction caused by glomerulonephritis. Prompt notification of the healthcare provider is essential to initiate antihypertensive therapy if indicated, implement closer monitoring for bleeding such as checking urine for gross hematuria, and prevent complications including hematoma formation, severe pain, hypotension, or further renal impairment.