A postpartum client is receiving morphine via a PCA pump after a cesarean birth. Which finding should be reported to the provider?

• A. Urine output 20 mL/hr
• B. Respirations 14 breaths/min
• C. Pain 2/10
• D. Blood pressure 130/85

Answer: (A)

Opioid analgesics used with a PCA after cesarean birth can slow many body functions, including bladder emptying. A urine output of about 20 mL per hour is significantly below the expected level (normal is roughly 0.5 mL/kg/hr, often at least 30 mL/hr for an average adult). This low output can indicate urinary retention, which is a known side effect of morphine that can be exacerbated by anesthesia and the postpartum state. If the bladder becomes distended, it can cause discomfort and lead to complications such as infection or kidney issues. Reporting this finding allows the provider to evaluate for urinary retention, perform a bladder scan, and determine whether catheterization or adjustments to analgesia or fluids are needed. The other findings—respirations 14 breaths per minute, pain 2/10, and blood pressure 130/85—are within expected ranges and don’t require urgent action.