SN provided skilled teaching to patient regarding management of dizziness/possible low Blood Pressure symptoms and recognition of red-flag signs that require immediate medical attention.

SN instructed patient that rising slowly from a sitting or lying position may help reduce dizziness and lightheadedness. Teaching included sitting at the edge of the bed for a few minutes before standing, performing ankle pumps or gentle leg movements prior to standing, and using a stable surface or assistive device for support when changing positions. Patient advised to avoid sudden position changes.

Education provided on lifestyle measures that may help ease symptoms, including avoiding alcohol, drinking adequate fluids throughout the day as not contraindicated by provider, and eating small, frequent, low-carbohydrate meals. SN encouraged patient to include fruits and vegetables as tolerated to support overall health and digestion.

SN emphasized the need to seek immediate medical evaluation for any of the following warning signs: fainting (loss of consciousness), breaking out in cold sweats associated with dizziness or feeling unwell, rapid and shallow breathing, or noticing blood in the stool (black, tarry, or bright red). Patient instructed to call 911 or go to the Emergency Room for these symptoms, and to notify PCP promptly of any new or worsening dizziness, chest pain, shortness of breath, or changes in mental status.

Patient was asked to:

• Describe how to change positions safely to help reduce dizziness.
• List at least two lifestyle changes they will make (hydration, meal changes, avoiding alcohol).
• Identify at least three red-flag symptoms that require immediate medical attention and what action to take.

Patient correctly stated that he/she will sit at the edge of the bed before standing, stand up slowly, and use support when getting up. Patient verbalized plan to avoid alcohol, increase water intake as allowed, and eat smaller, balanced meals with fruits and vegetables. Patient identified fainting, cold sweats, rapid shallow breathing, and blood in stool as reasons to seek emergency care and stated, “If that happens, I will call 911 right away.” Minimal cueing required.

Skilled nursing remains medically necessary to provide ongoing assessment of dizziness and Blood Pressure, reinforce safety teaching, monitor for changes in symptoms, and coordinate with PCP to prevent complications and potential rehospitalization.