Heart rate
🔴 The client’s heart rate increased from 92/min to 108/min, which requires immediate follow-up after pelvic and hip fractures.
🔴 Tachycardia can be an early sign of pain, internal bleeding, hypovolemia, shock, or worsening tissue injury.
🔴 Pelvic fractures are concerning because they can be associated with significant internal bleeding.
🔴 When tachycardia occurs with cool extremities, delayed capillary refill, and decreased pedal pulses, poor perfusion should be suspected.
🔴 The nurse should reassess pain, bleeding risk, circulation, blood pressure trends, urine output, and notify the provider.
Edema
🔴 The client’s sacral and iliac edema increased to 2+, which requires immediate follow-up.
🔴 Worsening edema after trauma can indicate soft tissue injury, bleeding, inflammation, or impaired circulation.
🔴 Increased swelling around the pelvis and hip can contribute to compression of surrounding blood vessels and nerves.
🔴 This finding is more concerning because the client also has cool lower extremities and reduced peripheral pulses.
🔴 The nurse should assess the affected area, compare extremities, monitor neurovascular status, and report worsening swelling.
Urine color
🔴 Dark reddish-brown urine after pelvic trauma requires immediate follow-up because it may indicate blood in the urine.
🔴 Pelvic fractures can be associated with urinary tract injury, including bladder or urethral trauma.
🔴 The client was unable to void and had bladder distention, which increases concern for urinary obstruction or injury.
🔴 Reddish-brown urine may also suggest muscle breakdown or bleeding, both of which require prompt evaluation.
🔴 The nurse should monitor urine output, catheter drainage, pain, vital signs, and notify the provider immediately.
Pedal pulses
🔴 The client’s pedal pulses decreased from +2 to +1 bilaterally, which requires immediate follow-up.
🔴 Decreased pulses indicate possible impaired peripheral perfusion after trauma.
🔴 This is especially concerning because the lower extremities are cool and capillary refill is delayed at 6 seconds.
🔴 Poor circulation can lead to tissue ischemia if not addressed quickly.
🔴 The nurse should perform frequent neurovascular checks, compare both extremities, and report changes promptly.
Oxygen saturation
🔴Oxygen saturation was 95% on Day 1, and no abnormal Day 2 oxygen saturation value is provided.
🔴Without evidence of hypoxia or respiratory decline, this is not one of the four immediate follow-up findings listed.
Temperature
🔴 The client’s temperature increased from 36.4°C to 37.2°C, but it remains within the expected range.
🔴 This does not require immediate follow-up compared with signs of possible bleeding, urinary injury, and impaired perfusion.