In post-nephrectomy care, which parameters best monitor fluid balance?

• A. Urine output and patient weight
• B. Blood pressure and heart rate every hour
• C. Wound healing and infection signs
• D. Respiratory rate and oxygen saturation

Answer: (A)

Monitoring fluid balance after nephrectomy hinges on quantifying what the body takes in and what it loses. The most informative indicators are urine output and body weight. Urine output directly reflects how the remaining kidney is processing fluids and excreting them as urine, which is essential after removing a kidney when the remaining organ must adapt to handle the fluid load. Tracking this hourly or regularly helps detect under- or overhydration early. Body weight serves as a practical measure of total fluid status; small, consistent changes in weight over a day or two mirror shifts in extracellular fluid and can signal fluid retention or dehydration that may not be obvious from other signs.

These two measures give a clear, quantitative picture of fluid balance, whereas other choices are less direct indicators. Blood pressure and heart rate can be influenced by many factors and don’t quantify fluid status precisely. Wound healing and infection signs relate to surgical recovery rather than fluid balance. Respiratory rate and oxygen saturation reflect respiratory or pulmonary status, which can be affected by fluid overload but are not direct gauges of overall fluid balance.