Which assessment finding is most concerning in a patient showing signs of sepsis?

Decreased urine output is a critical assessment finding in a patient presenting with signs of sepsis, as it often indicates impaired kidney function or acute kidney injury, which can occur in the setting of systemic infection and septic shock. The kidneys are particularly vulnerable during sepsis due to reduced perfusion and hypoxia. When the body's organs are not receiving adequate blood flow, the kidneys may struggle to filter waste and maintain fluid balance, leading to a drop in urine output.

This finding is concerning because it can signify a progression of sepsis towards more severe complications, including multi-organ dysfunction. Monitoring urinary output is essential for evaluating a patient's renal status and overall response to treatment. In contrast, nasal congestion, increased appetite, and stable vital signs—while they may be relevant to the patient's overall health—do not reflect the urgency or severity of the critical state often present in sepsis.