Medical Concerns

Call the doctor if you suspect a urinary tract infection (UTI). Signs of infection include cloudy and odorous urine, fever and pain with urination and/or blood-tinged urine. Also, let the doctor know if there is very little urinary output. Usually, a UTI is treated during regular office hours.

Call your doctor on an urgent basis if there is a large amount of blood in the stool, black stool, or blood leaking from the rectum. Note that sometimes small specks of blood are in the stool as a result of hemorrhoids, which is not an emergency, so the doctor could be made aware of this during regular hours.

Call the doctor during regular office hours for constipation (no stool for three days) or for diarrhea that lasts longer than 24 hours.

Also let the doctor know if your loved one is having high residuals from tube feedings. If residuals are high during the night, hold the tube feeding and call the doctor in the morning. Position your loved one at about 30 degrees in the bed (raise the head of the bed). Do not rest the individual flat on the bed when high residuals are present. Before you leave the hospital, ask the doctor what your loved one’s residuals should be and what amount would be considered too high. This will help you know when you should hold the feeding.

Call 911 if the person is having trouble breathing, cannot stop coughing or is having shallow breaths.

Call your doctor during regular office hours if your loved one has started a mild cough or is coughing up phlegm. Notice if a fever is present and note the color of the phlegm. Brown, green, yellow, or blood-tinged phlegm could mean that an infection is starting. Call your doctor at the first signs of infection.

If taking Coumadin, call the doctor on an urgent basis for any bleeding problems or large areas of bruising. Look for bleeding in the gums, urine, phlegm, stool, and saliva, and for excess bleeding from small cuts or scrapes or during the female menstrual period.

Call the doctor for new onset of fever. Try to figure out the cause of the fever so you can give the doctor a good picture of what is happening to your loved one. For example, is the patient coughing up colored phlegm? Is their urine cloudy or bloody? Are they having problems with vomiting or diarrhea? Notice how long the fever has been present and whether or not it seems to be relieved with acetaminophen.

Call 911 if the patient has a serious reaction, such as difficulty breathing, to any medicine.

Call your doctor during regular office hours for medicine refills. Call when you have about a one-week supply of medicine left so you do not run out before the prescription can be filled. Make appointments with your doctor during regular office hours for routine blood work. Some medicines require blood tests to know the drug is working safely in the body.

Never start taking new medicines or stop medicines without first talking to the doctor. This includes over-the-counter medicines, herbal remedies and vitamins. If you notice side effects from the medicines, let your doctor know.

Call 911 in any of these situations:

• First-time seizure
• Seizure that lasts more than two minutes
• The person stops breathing during/after the seizure.
• There is a change in alertness, or decreased ability to respond, even if it occurs a couple of hours after the seizure.
• The person has many seizures – one right after another.

Call the doctor instead of 911 if a person has a history of seizures, is on medicines for seizures, and does not have an emergency issue.

The doctor should always be called if a seizure happens.

Call the doctor if your loved one’s casts or splints are fitting poorly and if they are causing red spots, pinched areas, or swelling. Pay attention to increases in muscle tone or spasms.

Call the doctor on an urgent basis if you notice that there is redness, swelling, pain, and excess warmth to a leg or arm. This condition does not usually require a 911 call, but the doctor should be made aware as soon as possible. Do not massage the area. Keep it as still as possible. Keep the person in bed until the doctor gives you advice.

Call the doctor about simple swelling during regular office hours. General swelling of a leg or arm without redness, pain, and excess warmth is usually not an urgent problem.

Call 911 if you think the patient is having an emergency or gets so agitated that they are dangerous to others or themselves.

Call the doctor if you see changes in the patient’s level of alertness. It is important to let the doctor know if they are more drowsy than usual. Also, let your doctor know if they show signs of getting better. Some signs of improvement include showing more awareness of surroundings, following commands consistently, trying to speak, or acting agitated during the day. These issues can be mentioned during regular office hours.