Paired entries for this system. The left column is denial-bait; the right column is the same clinical picture written so a reviewer can see why a nurse was required.
Weak — does not survive
Why it fails
Strong — defensible
“Nose okay.”
No patency, bleeding, or cannula-skin assessment — a layperson observation.
“Nares patent bilaterally; no epistaxis; cannula skin intact at nares/columella/ears at 2 L/min; unchanged from baseline.”
“On oxygen.”
Records a fact, not cannula-skin surveillance.
“Continuous O2 at 2 L/min; skin under cannula and behind ears intact without pressure marks; padding in place; skin-care reinforced.”
“Had a nosebleed.”
No volume, no control, no anticoagulation context.
“Anterior epistaxis, moderate, controlled after 10 min firm pressure; on apixaban, BP 150/88; prevention taught; threshold to call reviewed.”
“Nose bleeding.”
No response to pressure, no escalation.
“Epistaxis not controlled after 15 min pressure, moderate volume, on apixaban, SBP 182; EMS activated; MD notified (see Anticoagulation/HTN).”
“Educated on oxygen.”
No content, no learner response.
“Cannula skin care and epistaxis control taught; caregiver return-demonstrated pressure technique and skin checks; verbalized when to call 911.”
“Skin under nose red.”
No offloading, no notification, no plan.
“Early erythema of nares under cannula, non-blanching; offloaded with padding, tubing repositioned; MD notified; reassess next visit (see Wounds).”
