A client develops a transfusion reaction. Which clinical response will the nurse assess to determine kidney damage?

A client develops a transfusion reaction. Which clinical response will the nurse assess to determine kidney damage?

• A. Glycosuria
• B. Blood in the urine
• C. Decreased urinary output
• D. Acute pain over the kidney

Answer: (C)

Monitoring kidney injury after a transfusion reaction hinges on noticing changes in urine production, because a drop in urine output directly reflects impaired kidney filtration and perfusion. In this scenario, the kidneys can be damaged by the hemolysis of transfused cells, with free hemoglobin and other byproducts that injure renal tubules and reduce urine formation. That makes decreased urinary output a sensitive and immediate indicator of evolving acute kidney injury. Glycosuria would point to issues with glucose handling or proximal tubule function, not specifically the filtration problems caused by a transfusion reaction. Blood in the urine can occur from hemolysis or disruption of the urinary tract, but it does not necessarily quantify how well the kidneys are filtering at that moment. Acute pain over the kidney is not a reliable or specific sign of transfusion-related kidney damage.

Monitoring kidney injury after a transfusion reaction hinges on noticing changes in urine production, because a drop in urine output directly reflects impaired kidney filtration and perfusion. In this scenario, the kidneys can be damaged by the hemolysis of transfused cells, with free hemoglobin and other byproducts that injure renal tubules and reduce urine formation. That makes decreased urinary output a sensitive and immediate indicator of evolving acute kidney injury.

Glycosuria would point to issues with glucose handling or proximal tubule function, not specifically the filtration problems caused by a transfusion reaction. Blood in the urine can occur from hemolysis or disruption of the urinary tract, but it does not necessarily quantify how well the kidneys are filtering at that moment. Acute pain over the kidney is not a reliable or specific sign of transfusion-related kidney damage.