A 68-year-old female resident of a skilled nursing facility has dysphagia after a stroke and receives a mechanical soft diet with thickened liquids. She is on a scheduled pain-management routine for osteoarthritis and has an indwelling urinary catheter. At the end of the shift, the LPN totals her intake and output record: oral intake 480 mL, IV fluids 250 mL, and urinary catheter output 150 mL over 8 hours. The resident's abdomen appears distended, and she reports suprapubic fullness. Her weight is unchanged from yesterday, and she tolerated her thickened liquids without coughing. What should the LPN do first?
- Continue the routine pain-medication schedule and report the urinary findings at the next weekly review.
- Round urine output to 200 mL to simplify the intake/output total.
- Replace the prescribed thickened liquids with unthickened fluids to increase intake, without consulting the care team.
- Check tubing and bag position without opening the system, and promptly report the urinary findings to the RN/provider.