A nurse is caring for a client who has end-stage liver disease and is being placed on a transplant list. Which of the following statements by the client is the priority for the nurse to report to the provider?

C. Using a raised toilet seat helps maintain the hips above the knees, which is recommended after THA to reduce strain on the hip joint and facilitate safer toileting. Keeping the hips higher than the knees helps prevent excessive flexion of the hip joint, which can strain the surgical site.

A Twisting at the waist places stress on the hip joint and can increase the risk of dislocation, which is a significant concern after THA surgery.

B. This option does not specify the correct procedure for using a walker

D. Heat application, such as using a heating pad, is not recommended for the operative hip after THA. Heat can increase blood flow and inflammation, potentially worsening pain and swelling.

Fluid volume deficit

The client is receiving Furosemide (a diuretic) at a significant dose (80 mg IV three times per day). This medication promotes diuresis to reduce fluid overload in heart failure. The client's weight decreased from 97.5 kg on admission to 90.7 kg on Day 2, indicating a fluid loss of approximately 6.8 kg (about 15 pounds). This substantial weight loss suggests a risk for fluid volume deficit, which can lead to hypovolemia and potential complications such as hypotension and decreased tissue perfusion.

Acute kidney injury (AKI)

The client's BUN level increased from 10 mg/dL on admission to 20 mg/dL on Day 2, which suggests impaired kidney function. This change may indicate a decrease in glomerular filtration rate due to decreased renal perfusion secondary to fluid loss from diuresis. AKI is a known complication in heart failure patients receiving diuretic therapy, especially if there is inadequate monitoring and adjustment of diuretic doses.