If there is a change from the client's baseline or an acute change on the ECG, what is the recommended action?

• A. Ignore the change
• B. Document the change only
• C. Assess the client, consider obtaining a 12-lead ECG, and report the change to the provider if appropriate
• D. Reassess after the next shift

Answer: (C)

When you see a change from the client’s baseline or an acute change on the ECG, take prompt, active steps: assess the patient, obtain a 12-lead ECG, and report the change to the provider if appropriate. This approach is essential because new or altered ECG patterns can indicate ischemia, infarction, arrhythmia, or electrolyte disturbances, and timely identification guides urgent treatment. Comparing the current tracing with the baseline helps determine if the finding is patient-specific and real, rather than an artifact. A 12-lead ECG provides a comprehensive view of the heart’s electrical activity, offering information that single-lead monitoring might miss and helping to localize potential problems. Simply documenting the change or waiting to reassess later does not address potential deterioration, and ignoring the change could miss a life-threatening event.