Most diseases or deteriorations of existing diseases are preceded by symptoms. The carer should try to notice these symptoms at an early stage and communicate his observations to the physician promptly.
Skin signs
Paleness combined with sweating, a rapid pulse and a feeling of weakness is a sign of shock and signals imminent acute circulatory failure
Yellowing of the skin as a sign of liver and gallbladder diseases
Blueness as a sign of deficient blood oxygenation
Redness in case of heat, excitement, high fever, high blood pressure or inflammatory processes
Oedema in venous disorders: restriction of heart action, kidney diseases
In the genital and anal area, especially watch for inflammation, bleeding, discharge, skin lacerations and external hemorrhoids
During nail and foot care check for nail changes (brittleness, deformation, discoloration, thickening) and fungus diseases. Check the oral mucous membrane for inflammations and whitish, adherent coatings.
Urine and feces
Urination three to four times within 24 hours is considered to be normal. If striking deviations from these averages are observable, the physician must be informed promptly. It is important to check the volume of urine particularly in elderly people because disorders in the fluid balancecan have severe consequences for them such as states of disorientation.
The color of the urine is light yellow and clear with a normal fluid intake, aqueous and light-colored with excessive intake. A dark yellow color is a sign of a severe loss of fluid or an insufficient fluid intake. A physician must be consulted if the urine is beer-brown, flesh-colored or cloudy with white flakes.
Frequency of defecation once or twice a day or at least every other day is considered to be normal. The color and composition of the feces are determined by the ingested food but can also be a sign of diseases. The patient must consult a physician if diarrhea persists or occurs in conjunction with fever, vomiting or admixtures such as mucus or blood, in case of obstinate constipation or if diarrhea and constipation alternate or blood is visible in the feces.
If the patient vomits, it must be noted when he vomits (time since the last meal), how he vomits (retching or projectile vomiting), how often he vomits and which admixtures are visible (blood, saliva, mucus, bile).
Expectoration or sputum
If the person in need of care suffers from bronchitis, bronchial asthma or pneumonia, the viscous consistency of the sputum is striking. Thin, light red and foamy sputum is a sign of an accumulation of fluid in the lung (frequently also of acute heart failure), however it could also be pneumorrhagia, pulmonary tuberculosis or lung cancer. Admixtures of pus are found in pulmonary abscesses.
