If a change from baseline is detected, what should you do?

• A. Wait until the next scheduled assessment
• B. Assess the patient, consider obtaining a 12-lead ECG, and report the change to the provider if appropriate
• C. Place a request for a lab test
• D. Change the patient’s medication without orders

Answer: (B)

When a change from baseline is detected on telemetry, the first step is to promptly assess the patient to determine if the change is clinically significant. This means checking the patient’s symptoms, vital signs, and overall appearance, and performing a quick bedside evaluation. A 12-lead ECG is important because it provides a full view of the heart’s electrical activity, helping to identify ischemia, arrhythmias, or conduction problems that might not be visible on a single-lead monitor. If the assessment and ECG raise concern, report the finding to the provider so they can decide on appropriate orders or interventions. This approach is time-sensitive and focused on direct clinical evaluation rather than delaying care or making changes without authorization.

Waiting for the next scheduled assessment could miss an evolving problem. Ordering a lab test without clinical indication may not address the immediate cardiac issue. Changing a medication without orders could cause harm.