A patient with suspected acute kidney injury presents with reduced urine output. What is the initial nursing action?

• A. Wait for lab results before acting.
• B. Increase IV fluids without assessment.
• C. Monitor intake and output and vital signs; ensure IV access; notify the provider.
• D. Remove IV access.

Answer: (C)

When acute kidney injury is suspected and urine output is reduced, the priority is to gather data and organize for prompt management. The initial nursing action is to monitor intake and output and vital signs, ensure IV access is available, and notify the provider. Tracking intake and output gives a clear picture of fluid balance and helps distinguish potential prerenal causes (like dehydration) from intrinsic kidney injury. Vital signs reveal perfusion and stability, guiding urgency and treatment needs. Keeping IV access ready allows rapid administration of fluids or medications and makes it possible to obtain necessary labs without delay. Notifying the provider promptly starts the diagnostic and therapeutic plan, including orders for labs (creatinine, BUN, electrolytes, urine analysis) and potential interventions. Delaying action until lab results are available, increasing IV fluids without assessment, or removing IV access would hinder timely care and risk patient safety.