Recognizing Warning Signs: When to Call Your Nurse

One of the most common concerns we hear from patients and family caregivers is some version of the same question: "How do I know when something is serious enough to call?" It's a fair and important question. The instinct to wait and see — to not want to bother anyone over something that might be nothing — can sometimes delay care that genuinely needed to happen sooner.

This guide is designed to give you a clear framework for making those calls. It won't cover every situation, but it addresses the most common warning signs we see in the home care setting and helps you distinguish between what can wait until morning, what should be addressed today, and what requires immediate emergency care.

Call 911 Immediately For

These signs indicate a potentially life-threatening emergency and should never prompt a call to your nurse first — go straight to emergency services:

• Chest pain, pressure, tightness, or pain radiating to the arm, jaw, or back
• Sudden difficulty breathing or feeling like you cannot catch your breath
• Sudden confusion, slurred speech, facial drooping, arm weakness, or vision changes (signs of stroke — use FAST: Face, Arms, Speech, Time)
• Loss of consciousness or unresponsiveness
• Severe allergic reaction (hives spreading rapidly, throat tightening, difficulty swallowing)
• Seizures in someone without a known seizure disorder, or a seizure lasting more than five minutes
• Uncontrolled bleeding that doesn't stop with direct pressure after 10 minutes

Call Your Nurse Promptly For

The following symptoms are not always emergencies but warrant a same-day nursing assessment or at minimum a phone consultation:

• Fever above 100.4°F — especially in elderly patients, immunocompromised individuals, or anyone who has had recent surgery or an invasive procedure.
• Significant change in blood pressure — readings consistently above 180/110 or below 90/60, especially with accompanying symptoms like headache, dizziness, or chest discomfort.
• Sudden weight gain of 2–3 pounds in 24 hours or 5 pounds in a week — this is a cardinal warning sign in heart failure patients indicating fluid retention.
• Worsening shortness of breath — especially with activities that previously did not cause breathlessness, or shortness of breath that wakes you from sleep.
• Signs of wound infection — increasing redness, warmth, swelling, pain, or drainage from a surgical site or any wound.
• New or worsening confusion in an elderly person — sudden onset confusion (delirium) in older adults is frequently a sign of an underlying medical problem such as urinary tract infection, medication toxicity, or electrolyte imbalance.
• Difficulty urinating or no urine output for more than eight hours
• Persistent nausea, vomiting, or diarrhea that prevents you from keeping medications or fluids down
• A fall — even if you feel fine. Falls in older adults often cause injuries that aren't immediately apparent, and a post-fall assessment is important.

Signs That Can Wait Until Your Next Scheduled Visit

Not everything requires immediate action. The following are worth mentioning at your next visit but generally don't require urgent intervention if you're otherwise stable:

• Mild fatigue that has been present for more than a few days but isn't worsening
• Minor skin irritation or rash not associated with a new medication
• Mild constipation (less than 3 days) without abdominal pain or distension
• Questions about a medication you've been taking without problems

Trust Your Instincts — And Call Anyway

If something feels wrong, that matters. Experienced nurses and physicians know that a patient saying "I just don't feel right" often precedes a clinically significant finding. You don't need a medical degree to recognize that someone you care for is not themselves today. When in doubt, call.

"I would always rather get a call that turns out to be nothing than have a family wait too long on something that needed attention. There are no unnecessary calls."
— Sue Volpe, RN

If your loved one has just left the hospital — the window when these warning signs matter most — our hospital discharge checklist covers what to have in place before problems arise.

NW Private Nurse Partners clients can reach Sue directly for guidance on any of these situations. New to our services? Call (224) 506-8600 — we're here to help.