What Should I Report to the Provider?
As a new nurse, you should be asking a lot of questions especially if something is abnormal with our patient. It is so important that you collaborate with providers and others on the interdisciplinary team. The more collaboration you have is the better chance for the patient to recover or improve their condition.
Never feel that you are asking a dumb question. If you are unsure of something you observe or do not understand you should make it a priority to get clarity. This can result in a positive outcome for a patient.
Below is a list of some common conditions that you will experience in the critical care environment and even in other parts of the healthcare system, potential causes, and reportable conditions.
INFECTION
Potential Causes:
Invasive devices (tubes, drains, intravascular devices)
Immunocompromise
Debilitated patient condition
Aspiration
Prolonged immobility
Wounds (traumatic, surgical, pressure ulcer)
Redness, swelling, foul odor, and/or exudates from catheter insertion site or wound
Decreased tissue perfusion
Diabetes mellitus
Reportable Conditions
Fever
Redness, swelling, foul odor, and/or exudates from catheter insertion site or wound
Increased or decreased white blood cell count
Results of cultures (blood, urine, sputum, wound)
HYPOXEMIA
Potential Causes:
Low cardiac output state (hypovolemia, cardiogenic shock, cardiac tamponade)
Hypoventilation (central nervous system depression, thoracic surgery, pneumothorax)
Intrapulmonary shunting (pneumonia, pulmonary edema, atrial or ventricular septal defects)
Ventilation/perfusion mismatch (pulmonary embolus, increased secretions, bronchospasm)
Diffusion defects (thickened alveolar capillary membrane, increased fluid in interstitial space)
Reportable Conditions
Dyspnea
Tachypnea
Tachycardia
Dysrhythmias
Chest pain
Hypertension with increased heart rate
Hypotension with decreased heart rate
Anxiety, restlessness
Coma
Pallor
Cool, dry skin
Cyanosis
Diaphoresis (late)
BLEEDING
Potential Causes:
External and internal fluid losses (hemorrhage, third spacing)
Expanding hematoma
Reportable Conditions
Hypotension
Tachycardia
Tachypnea
Oliguria
Cool, pale skin
Decreased hemoglobin/hematocrit
Frank bleeding
Anxiety decreased level of consciousness
DYSRHYTHMIAS
Potential Causes:
Electrolyte imbalances
Hypoxia
Hypothermia
Hyperparathyroidism
Digitalis toxicity
Myocardial ischemia, injury, infarction
Acid-base imbalances
Medications
Reportable Conditions
Change in heart rate or rhythm
Palpitations
Syncope
Hypotension
Abnormal electrolyte values
ST-segment changes
Abnormal cardiac enzymes
Chest pain
References:
uptodate.com, clinicalkey nursing, merck manual professional