Advance FNP Clinical Soap Note #3

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Home>Homework Answsers>Nursing homework helpnursing7 months ago23.11.202412Report issuefiles (2)SOAPNOTE.docxSOAPNoteTemplate.docxSOAPNOTE.docxA SOAP note is a method of documentation employed by healthcare providers to record and communicate patient information in a clear, structured, and in an organized manner. This assignment will provide students with the necessary tools to document patient care effectively, enhance their clinical skills, and prepare them for their roles as competent healthcare providers.Instructions:SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below.For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:S=Subjective data: Patient’s Chief Complaint (CC).O=Objective data: Including client behavior, physical assessment, vital signs, and meds.A=Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.P=Plan: Treatment, diagnostic testing, and follow upSubmission Instructions:· Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.· You must use the template provided. Turnitin will recognize the template and not score against it.SOAPNoteTemplate.docxSOAP NOTE TEMPLATEReview the Rubric for more GuidanceDemographicsChief Complaint (Reason for seeking health care)History of Present Illness (HPI)AllergiesReview of Systems (ROS)General:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:Nutrition:Sleep/Rest:LMP:STI Hx:Vital SignsLabsMedicationsPast Medical HistoryPast Surgical HistoryFamily HistorySocial HistoryHealth Maintenance/ ScreeningsPhysical ExaminationGeneral:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:DiagnosisDifferential DiagnosisICD 10 CodingPharmacologic treatment planDiagnostic/Lab TestingEducationAnticipatory GuidanceFollow up planPrescriptionSee Below (scroll down)ReferencesGrammarEA#: 101010101 STU Clinic LIC# 10000000Tel: (000) 555-1234 FAX: (000) 555-12222Patient Name: (Initials)______________________________ Age ___________Date: _______________RX ______________________________________SIG:Dispense: ___________ Refill: _________________No SubstitutionSignature:____________________________________________________________Signature (with appropriate credentials):_____________________________________References (must use current evidence-based guidelines used to guide the care [Mandatory])SOAPNoteTemplate.docxSOAP NOTE TEMPLATEReview the Rubric for more GuidanceDemographicsChief Complaint (Reason for seeking health care)History of Present Illness (HPI)AllergiesReview of Systems (ROS)General:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:Nutrition:Sleep/Rest:LMP:STI Hx:Vital SignsLabsMedicationsPast Medical HistoryPast Surgical HistoryFamily HistorySocial HistoryHealth Maintenance/ ScreeningsPhysical ExaminationGeneral:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:DiagnosisDifferential DiagnosisICD 10 CodingPharmacologic treatment planDiagnostic/Lab TestingEducationAnticipatory GuidanceFollow up planPrescriptionSee Below (scroll down)ReferencesGrammarEA#: 101010101 STU Clinic LIC# 10000000Tel: (000) 555-1234 FAX: (000) 555-12222Patient Name: (Initials)______________________________ Age ___________Date: _______________RX ______________________________________SIG:Dispense: ___________ Refill: _________________No SubstitutionSignature:____________________________________________________________Signature (with appropriate credentials):_____________________________________References (must use current evidence-based guidelines used to guide the care [Mandatory])SOAPNOTE.docxA SOAP note is a method of documentation employed by healthcare providers to record and communicate patient information in a clear, structured, and in an organized manner. This assignment will provide students with the necessary tools to document patient care effectively, enhance their clinical skills, and prepare them for their roles as competent healthcare providers.Instructions:SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below.For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:S=Subjective data: Patient’s Chief Complaint (CC).O=Objective data: Including client behavior, physical assessment, vital signs, and meds.A=Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.P=Plan: Treatment, diagnostic testing, and follow upSubmission Instructions:· Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.· You must use the template provided. Turnitin will recognize the template and not score against it.SOAPNoteTemplate.docxSOAP NOTE TEMPLATEReview the Rubric for more GuidanceDemographicsChief Complaint (Reason for seeking health care)History of Present Illness (HPI)AllergiesReview of Systems (ROS)General:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:Nutrition:Sleep/Rest:LMP:STI Hx:Vital SignsLabsMedicationsPast Medical HistoryPast Surgical HistoryFamily HistorySocial HistoryHealth Maintenance/ ScreeningsPhysical ExaminationGeneral:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:DiagnosisDifferential DiagnosisICD 10 CodingPharmacologic treatment planDiagnostic/Lab TestingEducationAnticipatory GuidanceFollow up planPrescriptionSee Below (scroll down)ReferencesGrammarEA#: 101010101 STU Clinic LIC# 10000000Tel: (000) 555-1234 FAX: (000) 555-12222Patient Name: (Initials)______________________________ Age ___________Date: _______________RX ______________________________________SIG:Dispense: ___________ Refill: _________________No SubstitutionSignature:____________________________________________________________Signature (with appropriate credentials):_____________________________________References (must use current evidence-based guidelines used to guide the care [Mandatory])SOAPNOTE.docxA SOAP note is a method of documentation employed by healthcare providers to record and communicate patient information in a clear, structured, and in an organized manner. This assignment will provide students with the necessary tools to document patient care effectively, enhance their clinical skills, and prepare them for their roles as competent healthcare providers.Instructions:SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below.For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:S=Subjective data: Patient’s Chief Complaint (CC).O=Objective data: Including client behavior, physical assessment, vital signs, and meds.A=Assessment: Diagnosis of the patient’s condition. Include differential diagnosis.P=Plan: Treatment, diagnostic testing, and follow upSubmission Instructions:· Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.· You must use the template provided. Turnitin will recognize the template and not score against it.SOAPNoteTemplate.docxSOAP NOTE TEMPLATEReview the Rubric for more GuidanceDemographicsChief Complaint (Reason for seeking health care)History of Present Illness (HPI)AllergiesReview of Systems (ROS)General:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:Nutrition:Sleep/Rest:LMP:STI Hx:Vital SignsLabsMedicationsPast Medical HistoryPast Surgical HistoryFamily HistorySocial HistoryHealth Maintenance/ ScreeningsPhysical ExaminationGeneral:HEENT:Neck:Lungs:CardioBreast:GI:M/F genital:GU:NeuroMusculo:Activity:Psychosocial:Derm:DiagnosisDifferential DiagnosisICD 10 CodingPharmacologic treatment planDiagnostic/Lab TestingEducationAnticipatory GuidanceFollow up planPrescriptionSee Below (scroll down)ReferencesGrammarEA#: 101010101 STU Clinic LIC# 10000000Tel: (000) 555-1234 FAX: (000) 555-12222Patient Name: (Initials)______________________________ Age ___________Date: _______________RX ______________________________________SIG:Dispense: ___________ Refill: _________________No SubstitutionSignature:____________________________________________________________Signature (with appropriate credentials):_____________________________________References (must use current evidence-based guidelines used to guide the care [Mandatory])12Bids(63)Dr. Ellen RMMISS HILLARY A+Dr. Aylin JMProf Double RProf. TOPGRADEEmily ClareDr. Sarah Blakefirstclass tutorDoctor.NamiraDemi_Rosesherry proffMUSYOKIONES A+Dr ClovergrA+de plusSheryl HoganProWritingGuruDr. Everleigh_JKColeen AndersonIsabella HarvardBrilliant GeekShow All Bidsother Questions(10)Project 2aFind the following values for a lump sum assuming annual compoundingNovel: Shift by Em Bailey

 

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