When monitoring a client after a kidney transplant, which of the following findings would indicate a potential acute rejection of the transplant?

After a kidney transplant, the immune system may recognize the transplanted organ as foreign and initiate an inflammatory response known as acute rejection. This typically occurs within days to months post-transplant and can compromise graft function if not identified early. Clinical monitoring focuses on early signs of inflammation, reduced renal function, and systemic changes indicating immune activation. Prompt recognition is essential to preserve graft viability and prevent irreversible damage. Rationale: A. Fever and fluid retention are key indicators of potential acute rejection. Fever reflects an inflammatory or immune response against the transplanted kidney. Fluid retention occurs due to impaired renal function as the rejecting kidney loses its ability to regulate fluid balance effectively, often leading to edema and hypertension. B. A steady increase in urine output is not typically associated with acute rejection and may instead indicate improving graft function or appropriate response to therapy. In acute rejection, urine output more commonly decreases due to declining renal function and reduced glomerular filtration. C. Decreased blood creatinine levels suggest improved kidney function rather than rejection. In acute rejection, serum creatinine typically rises due to impaired filtration and declining graft performance. A downward trend in creatinine is a reassuring finding, not a warning sign. D. Increased appetite and weight gain are not specific indicators of acute transplant rejection. While weight gain may occur due to fluid retention, increased appetite alone is not associated with immune-mediated graft dysfunction. More specific signs such as fever, rising creatinine, and reduced urine output are more clinically relevant.