A 22-year-old client with type 1 diabetes is on postoperative day 2 after femur fixation. An indwelling catheter drains to a closed bag below bladder level. Blood pressure is 108/66 mm Hg, down from 122/78 two hours ago; pulse is 112/minute, respirations 20/minute, temperature 37.4°C and SpO2 97% on room air. Only 15 mL of dark urine has been collected in 4 hours. Blood glucose is 148 mg/dL. Which action should the LPN take first?
- Wait an hour to repeat the temperature before deciding whether the findings need reporting.
- Irrigate the catheter before checking the tubing and drainage system for an obstruction.
- Record the findings and wait for the next routine assessment before contacting the RN.
- Promptly alert the RN to the low output and circulatory changes, while checking for a simple drainage obstruction.