her hourly
urine output should have been 37.5 mL. The nurse reviewed
the laboratory results, noting that Ms. Jansen’s serum creatinine had increased by 0.4 mg/dL over her preoperative level. Knowing that long durations of
low urine output are associated with poor outcomes,
the nurse immediately notified the surgeon and hospitalist
and administered the prescribed fluid boluses
without delay. After the second hour of low urine output, the nurse requested that Ms. Jansen be transferred
to the ICU,