Abnormal findings and what they may signal — each warrants Mode B focused documentation and, where parameters are met, intervention and notification:
Acute distress — mild, moderate, or severe — or an ill or toxic appearance.
Disheveled appearance or a decline in self-care and hygiene.
Lethargy, reduced engagement, or altered interaction.
Cachexia, an apparently malnourished or dehydrated appearance, or new unintentional weight loss.
Fever or chills; profound fatigue or malaise; appetite loss; night sweats.
Functional decline from baseline.
A symptom cluster suggesting a systemic process — fever with tachycardia and tachypnea and altered mentation (sepsis), or fatigue with weight loss and night sweats (warranting evaluation).
