In assessing a patient's sedation level, which of the following would indicate they require immediate sedation adjustment?

A RASS score increasing to +3 indicates that the patient is highly agitated or possibly out of control, requiring immediate intervention. In the context of sedation management, a score at this level suggests that the sedation is insufficient to ensure the patient's safety and comfort. When a patient's level of sedation is inadequate, they may experience increased anxiety or agitation, which could compromise their ability to cooperate with medical procedures and increase the risk of injury.

In contrast, a consistent RASS score of -2 indicates a moderate sedation level, which generally suggests that the patient is calm and cooperative, albeit slightly sedated. A score returning to 0 reflects a patient who is alert and can interact normally, thus not requiring sedation adjustment. Fluctuation between -1 and +1 shows varying levels of calmness and alertness, which might still be acceptable and manageable without immediate action.

Therefore, the rising RASS score to +3 necessitates prompt adjustment to ensure the patient remains safe and their sedation needs are effectively met.