Which of the following symptoms could necessitate an immediate referral to a physician in home health care?

An immediate referral to a physician is warranted in the case of sudden changes in condition or severe pain because these symptoms can indicate a significant shift in the patient's health status that requires prompt medical evaluation. Sudden changes may suggest the emergence of complications or exacerbations of underlying conditions that could lead to serious consequences if not addressed quickly. Severe pain, in particular, often serves as a warning sign that something is critically wrong and may require urgent intervention.

In contrast, minor headaches and fatigue could be managed with home care interventions and do not typically signify an immediate threat to health. Normal seasonal allergies are generally non-life-threatening and can usually be treated with over-the-counter medication. Stable chronic conditions indicate that the patient’s health is currently well managed and does not suggest an immediate risk. These conditions do not necessitate the urgency of a physician's referral unless there are changes that indicate a deterioration in the patient's status.