Which of the following is the warning sign post renal transplantation?

Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Medical & Surgical Nursing

Easy

Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)

Explanation

A decrease in urine output (oliguria) is a primary warning sign of complications after a renal transplant.
Oliguria is defined as a urine output of less than 400 mL in 24 hours or less than 0.5 mL/kg/hr.
This sign can indicate serious issues such as acute graft rejection, vascular thrombosis (blood clot), or urinary obstruction.
Prompt recognition and reporting of decreased urine output are crucial for timely intervention to save the transplanted kidney.

Option B: Increased urine output (polyuria) is usually a positive sign after a transplant, indicating the new kidney is functioning and removing excess fluid accumulated before the surgery. It is not considered a warning sign for rejection.
Option C: Pale-colored urine is a sign of good hydration and a well-functioning kidney that is effectively diluting waste products. It is a desired outcome, not a warning sign.
Option D: This option is incorrect because only decreased urine output is a definitive warning sign. Increased urine output is typically a favorable sign.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Post-operative monitoring and complications of renal transplantation as background academic context rather than a clinical decision trigger.
Nurses play a critical role in monitoring patients after renal transplantation. Strict intake and output monitoring is a priority nursing intervention.
Any urine output falling below 0.5 mL/kg/hr for more than two consecutive hours must be reported to the medical team immediately for investigation.
What if? If a post-transplant patient suddenly develops a fever and graft site tenderness along with decreased urine output, the suspicion for acute rejection increases significantly, warranting immediate immunological assessment and possibly a biopsy.

How to Approach the Question

First, identify the core of the question, which is asking for a 'warning sign' after a renal transplant.
Think about the function of a healthy kidney: it produces urine. A failure or problem with the kidney would logically lead to a decrease in its primary function.
Evaluate the options based on this physiological principle.
Option A (Decreased urine output) directly reflects a failure in kidney function, making it a strong candidate for a warning sign.
Option B (Increased urine output) suggests the kidney is working, perhaps even very well, which is generally not a warning.
Option C (Pale color urine) indicates dilute urine, a sign of good function, not a warning.

Concept Tested & Keywords

Concept Tested: Post-operative monitoring and complications of renal transplantation.
Stem keywords: warning sign, post renal transplantation
Lead-in keywords: Which
Negative lead-in flag: false

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