When there is a change from baseline, which action is appropriate?

• A. Ignore the change
• B. Postpone any further assessment
• C. Assess the client, consider obtaining a 12-lead ECG, and report the change to the provider if appropriate
• D. Document and finish

Answer: (C)

A change from baseline on telemetry signals a possible new or evolving cardiac problem that needs immediate attention. The safest and most effective response is to assess the patient now—check for symptoms like chest pain, shortness of breath, dizziness, or fainting; review vital signs and overall perfusion; and look for any signs of instability. Then obtain a 12-lead ECG to get a clearer picture of what’s happening with the heart’s rhythm and any ischemic changes. This additional data helps determine whether the change is due to a new arrhythmia, evolving ischemia, electrolyte disturbances, or a device-related issue, and it guides the next steps. If the patient appears unstable or the ECG shows concerning findings, report to the provider so timely treatment can be started. Documentation and continued monitoring follow, but the change should not be ignored or postponed.