E9 · Very little urine being made
Actual ⚠ URGENT Elimination
Definition
Urine output is lower than expected, which may signal dehydration or kidney trouble.- Dehydration
- kidney failure
- blocked catheter
- low blood pressure
- heart problems
- Less urine than expected each hour
- dark urine
- swelling
- weight gain
📋 Scenario
A patient after surgery makes only 100 ml of urine in 6 hours.
Subjective (S): "I haven't passed much urine today."
Objective (O): Urine output 100 ml in 6 hours; blood pressure 98/60; dry mouth; post-operative day 1.
Assessment tools for this scenario: CP-ELIM Elimination Check CP-SKIN Skin & Wound Score CP-BREATH Breathing & Circulation Check
Validated scales to consider: Bristol Stool Chart, bladder scan, Braden Scale, TIME wound chart, NEWS2, SpO₂, ECG
**CarePath diagnosis:** Very little urine being made related to dehydration, as evidenced by less urine than expected each hour and dark urine.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Measure output accurately. | Accurate measurement shows whether the kidneys are making enough urine, which is a key sign of fluid balance and blood flow to the organs. |
| Check the catheter for kinks. | A kinked or blocked catheter can stop urine draining, so checking it separates a drainage problem from truly low urine production. |
| Encourage fluids if allowed. | Extra fluid can restore blood volume when dehydration is the cause, but it is given only if allowed because some patients must limit fluids. |
| Report low output. | Low output may signal dehydration, low blood pressure or kidney trouble, so the doctor needs to know early to find and treat the cause. |
| Check blood pressure. | Low blood pressure means the kidneys may not receive enough blood flow, so checking it shows whether urine output is likely to improve. |
**Expected outcomes**
- Within 6 hours: urine output at least about 30 ml per hour, blood pressure and pulse within normal range.
- Patient drinks as allowed.
**Linking the data to the diagnosis**
On post-operative day 1 the patient made only 100 ml of urine in 6 hours and says not much urine has been passed today. The nurse also found a blood pressure of 98/60 and a dry mouth. These findings show the problem is present, so it is an actual diagnosis, with dehydration as the likely cause. Output and blood pressure are linked, which is why both are watched, and any catheter is checked so a drainage problem is not missed. The plan aims within 6 hours for urine output of at least about 30 ml per hour, blood pressure and pulse in the normal range, and the patient drinking as allowed.
CarePath diagnosis
Very little urine being made related to dehydration, as evidenced by less urine than expected each hour and dark urine.
Interventions and rationale
Listed in priority order — for urgent statements the first action is to get help.
| Intervention | Rationale |
|---|---|
| 1. Measure output accurately. | Accurate measurement shows whether the kidneys are making enough urine, which is a key sign of fluid balance and blood flow to the organs. |
| 2. Check the catheter for kinks. | A kinked or blocked catheter can stop urine draining, so checking it separates a drainage problem from truly low urine production. |
| 3. Encourage fluids if allowed. | Extra fluid can restore blood volume when dehydration is the cause, but it is given only if allowed because some patients must limit fluids. |
| 4. Report low output. | Low output may signal dehydration, low blood pressure or kidney trouble, so the doctor needs to know early to find and treat the cause. |
| 5. Check blood pressure. | Low blood pressure means the kidneys may not receive enough blood flow, so checking it shows whether urine output is likely to improve. |
Expected outcomes
- Within 6 hours: urine output at least about 30 ml per hour, blood pressure and pulse within normal range.
- Patient drinks as allowed.
Linking the data to the diagnosis
On post-operative day 1 the patient made only 100 ml of urine in 6 hours and says not much urine has been passed today. The nurse also found a blood pressure of 98/60 and a dry mouth. These findings show the problem is present, so it is an actual diagnosis, with dehydration as the likely cause. Output and blood pressure are linked, which is why both are watched, and any catheter is checked so a drainage problem is not missed. The plan aims within 6 hours for urine output of at least about 30 ml per hour, blood pressure and pulse in the normal range, and the patient drinking as allowed.