Decompensation

4-lb gain over 48 h, new 3+ edema, bibasilar crackles, JVD, new S3 — parameter-based diuretic applied, SBAR 14:10, higher dose + BMP/BNP ordered, dose witnessed 14:25, representative notified 14:30, relief after voiding; reassess next shift; supports Section N.

GDMT intolerance

Symptomatic hypotension (BP 92/54, lightheaded) after the beta-blocker/ARNI — dose held per parameters, provider notified, adjustment and repeat labs ordered, monitoring; reassess; supports Section N.

Acute pulmonary edema

Sudden severe dyspnea with frothy sputum and SpO₂ 85% — EMS activated/transfer per policy, O₂ and positioning while awaiting transport, provider and representative notified; serial vitals and the event documented.

General cardiac exam, arrhythmia, and ACS route to the Cardiovascular reference; anticoagulation for AF/VTE routes to the Anticoagulation overlay; cardiac dyspnea shares the Respiratory reference; the sodium/fluid plan routes to the Nutrition reference.