In which situation should a nurse immediately report a change in a patient's vital signs?

A nurse should immediately report a change in a patient's vital signs when there are significant fluctuations from baseline measurements. Baseline vital signs reflect the patient's normal state of health, and any substantial deviations—whether high or low—can indicate an emergent medical condition or critical change in the patient's status. For instance, a sudden increase in heart rate or blood pressure might suggest pain, anxiety, or a developing infection, while a drop could indicate shock or impending organ failure. Recognizing and responding to these changes promptly is crucial for patient safety and effective nursing practice.

In contrast, normal fluctuations or variations that fall within established normal limits would not typically warrant immediate reporting, as they are expected in stable patients. Likewise, if the patient is stable and feeling well, these vital signs are likely to reflect their ordinary condition. Reporting would not be necessary until there is evidence of distress or deterioration. Additionally, a patient being asleep does not inherently signal the need for extra reporting unless accompanied by significant and concerning changes in vital signs; fluctuations should always consider the patient's context and overall stability.