05 Jan CONPH NSG6020 Subjective, Objective, Assessment, Plan (SO
SEE ATTACHED DOCUMENTS FOR INSTRUCTIONS AND TEMPLATE
DUE DATE JANUARY 3, 2025
NO PLAGIARISM ACCEPTED MORE THAN 10%, THIS ASSIGNMENT IS SUBMITTED BY TURNIN IN
CONPH NSG6020 Subjective, Objective, Assessment, Plan (SOAP) Notes
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Student Name: |
Course: |
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Patient Name: (Initials ONLY) |
Date: |
Time: |
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Ethnicity: |
Age: |
Sex: |
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SUBJECTIVE (must complete this section) |
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CC: |
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HPI: |
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Medications: |
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Previous Medical History: Allergies: Medication Intolerances: Chronic Illnesses/Major traumas: Hospitalizations/Surgeries: |
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FAMILY HISTORY (must complete this section) |
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M: MGM: MGF: F: PGM: PGF: |
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Social History: |
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REVIEW OF SYSTEMS (must complete this section) |
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General: |
Cardiovascular: |
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Skin: |
Respiratory: |
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Eyes: |
Gastrointestinal: |
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Ears: |
Genitourinary/Gynecological: |
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Nose/Mouth/Throat: |
Musculoskeletal: |
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Breast: |
Neurological: |
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Heme/Lymph/Endo: |
Psychiatric: |
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OBJECTIVE (Document PERTINENT systems only. Minimum 3) |
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Weight: |
Height: |
BMI: |
BP: |
Temp: |
Pulse: |
Resp: |
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General Appearance: |
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Skin: |
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HEENT: |
10122023 Page 1 of 2
CONPH NSG6020 Subjective, Objective, Assessment, Plan (SOAP) Notes
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Cardiovascular: |
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Respiratory: |
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Gastrointestinal: |
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Breast: |
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Genitourinary: |
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Musculoskeletal: |
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Neurological: |
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Psychiatric: |
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Lab Tests: |
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Special Tests: |
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DIAGNOSIS |
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Differential Diagnoses · 1- Diagnosis, (ICD 10 code): · 1- Diagnosis, (ICD 10 code): |
Diagnosis • |
1- Presumptive diagnosis (ICD 10 code): |
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Plan/Therapeutics: |
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Diagnostics: |
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Education: |
10122023 Page 2 of 2
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INSTRUCTIONS
TOPIC: ( DIAGNOSIS) MYOCARDIAL INFARCTION
– PLEASE COMPLETE THE SOAP NOTE ACCORDING TO THE TEMPLATE ATTACHED, ALL SECTIONS MUST BE PROPERLY COMPLETED, NO PLAGIARISM IS BY TURNIN IN SUBMITTED.
– CREATE A CASE (SOAP NOTE) LIKE YOU AS A PRIMARY DOCTOR IN A FAMILY CLINIC IN MIAMI FLORIDA, IS HAVING A PATIENT WITH GASTROENTERITIS IN THE VISIT.
– YOU MUST COMPLETE EACH SECTION IN THE SOAPS NOTE TEMPLATE FROM TOP TO BOTTOM.
LAST SECTION IS VERY IMPORTANT: ( INCLUDE):
-1 MAIN DIAGNOSIS *( GASTROENTERITIS)
-3 DIFFERENTIAL DIAGNOSIS WITH ITS EXPLANATION -PLAN AND THERAPEUTICS: WHICH MEANS: MEDICATION TREATMENT WITH ITS FULL EXPLANATION AND HOW MUST BE TAKE , DOSE, ROUTE, FREQUENCY . SIDE EFFECTS
– WHAT TYPE OF DIAGNOSTICS EXAMS WERE ORDERED
-EDUCATION PROVIDED TO PATIENT
– FOLLOW U-/ REFERRALS
– 3-4 REFERENCES NO OLDER THAN 5 YEARS WITH SCHOLARLY RESOURCES.
– NO PLAGIARISM MORE THAN 10% THIS SOAP WILL BE SUBMITTED BY TURNIN IN.
– COMPLETE ALL SECTIONS AS REQUESTED ABOVE PROPERLY
-DUE DATE JANUARY 3, 2025
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