VIEW COMPLETED NOTE

Patient identified with Name, DOB, ID and Address prior to perform all procedures. SN performed skilled observation and assessment, monitored vital signs, assessed mental, physical and behavioral status. Instructed, evaluated and assessed pt compliance, effectiveness and side effects to medications. Instructed on diet plan. Assessed patient understanding of disease process. Patient education provided. Assessed & educated patient knowledge of signs and symptoms re: complications necessitating medical attention. Instructed patient in any knowledge deficit. Assessed home for safety & Risks for Falls. Safety & preventative education provided. Implemented safety measures as needed. SN accessed Midline to right arm, there is no s/s of infection IV site is healthy. SN checked blood return. SN flushed IV line with 10 ml sterile normal saline 0.9%, line was patent and flowed freely with no resistance. SN infused Meropenen 1 gm in 100 ml of NSS over 30 minutes via Midline and gravity with a control rate of infusion at 200 ml/hr once daily for 7 days. After infusion, SN flushed line with 10ML of sterile saline followed by 3-5 ml Heparin flush (10 units/ml). Patient tolerated procedure well without complaint or complications. Standard and universal precautions were used. Patient is unable to perform self-infusion due: complexity of procedure. Patient is unable to learn the technique to safely infused this medication due: functional, physical, and mental limitations. There is no caregiver willing and able to perform this skilled care. SN instructed patient/caregiver on signs of central catheter problems. The signs of catheter infection and problems are similar for all types of central venous catheters. If you have any sign of infection or catheter problem, call your doctor immediately. In addition, signs of infection, clotting, or other problems include: Redness, tenderness, drainage, warmth, or odor around the catheter site Fever of 100.5F (38 C) or greater, or chills, swelling of the face, neck, chest, or arm on the side where your catheter is inserted, leakage of blood or fluid at the catheter site or the cap, inability to flush the catheter, or resistance to flushing the catheter, displacement or lengthening of the catheter. Patient/caregiver verbalized understanding teaching.