The patient's pulse was irregular as noted in the vitals section. Patient was queried about acute changes in symptoms. Patient denies any symptoms of irregular pulse including: chest pain, Heart palpitations, Chest discomfort, Dizziness or Lightheadedness, Fainting (Syncope) and weakness. Therefore there were no symptoms that necessitated contacting the provider. The medical emergency plan that necessitates contacting the home health team, the physician, or going to the ER was reviewed.