A 52-year-old man is recovering on the medical-surgical unit after a transurethral resection of the prostate (TURP) performed yesterday. The plan of care specifies continuous bladder irrigation with normal saline titrated to keep drainage light pink, intake and output monitoring, and vital signs every 4 hours. His baseline vital signs since surgery have been stable: heart rate 78–84/min, blood pressure 122/78 mmHg. On this shift, the LPN obtains his vital signs directly and finds a heart rate of 118/min and blood pressure of 96/58 mmHg, with the drainage bag now containing bright red output with visible clots. The client also reports feeling dizzy when he sits up. What should the LPN do first?
- Revise the plan of care to add closer monitoring based on this shift's findings alone.
- Report the vital sign changes and bright red drainage with clots to the RN immediately.
- Increase the irrigation rate independently to clear the clots before rechecking vitals.
- Document the findings as an expected postoperative change and continue routine care.