VIEW COMPLETED NOTE

Patient identified by name, ID with picture and facial recognition. SN performed skilled observation and assessment of all body systems from head to toe. No signs or symptoms of acute distress noted. SN assessed home for safety & Risks for fall. Safety & preventative education. SN performed skilled observation and assessment, monitored vital sign and blood pressure and found them within normal limits. SN assessed mental and physical status, evaluated compliance, effectiveness and side effects of medication, diet and nutritional status, and patient’s and/or caregiver’s knowledge of signs and symptoms of complication. SN prepared and administered 1 gm of Entaperen to right upper outer posterior buttock (Dorsogluteal), once daily. Patient tolerated injection well without bleeding at site, complaint or complication. Standard and universal precautions were used. Patient is unable to perform injection due complexity of procedure. Patient is unable to learn the technique to safely inject this medication due complexity of procedure. There is no caregiver willing and available to perform this skilled care. SN instructed patient / caregiver call your doctor or healthcare provider right away if you experience: severe pain at the injection site tingling or numbness, redness, swelling, or warmth at the injection site drainage at the injection site prolonged bleeding signs of an allergic reaction, such as difficulty breathing or facial swelling. Patient/caregiver verbalized understanding teaching.