What is the best nursing response for a client reporting painless gross hematuria?

• A. Reassure patient it's common
• B. Increase fluids and monitor
• C. Send urine sample to lab only
• D. Report this to the provider promptly

Answer: (D)

Painless gross hematuria is a red-flag symptom because it can signal serious underlying conditions that need prompt evaluation, such as bladder or kidney cancer, stones, infection, or coagulopathy. The best nursing action is to report to the provider promptly so an expedited diagnostic work-up can be initiated (urinalysis with microscopic analysis, possible urine culture, imaging like a CT urogram, and appropriate referrals). In the meantime, assess the patient’s stability (vital signs, signs of bleeding or dehydration), collect a urine sample and document details about the onset, duration, amount, color, and any associated symptoms or risk factors (such as anticoagulant use or smoking). Reassuring the patient or delaying evaluation with only fluids or lab tests could miss a serious condition, so prompt escalation is essential.