Breast is free from masses or tenderness, no discharge, no dimpling, wrinkling or discoloration of the skin. Alert and oriented; answers questions appropriately. S1, S2 with regular rate and rhythm. Alert and oriented; answers questions appropriately. Rectal as appropriate: no evidence of hemorrhoids, fissures, bleeding or masses. Include three differential diagnoses and support your diagnoses with supporting literature. PMI noted at 5thICS MCL. Pharynx is nonerythematous and without exudate. I know that normal is used in chartingbut you are learning and so you are required to do the ideal and the ideal is describing what you see and completing a total ROS on every patient. Flu shot in October 2012 and plans to get the Flu vaccine this year. Chronic Illnesses/Major traumas:Patient has a significant history for hypertensionChronic Health Problems: Immunizations:Up to date on all immunizations. Exercise and leisure: Walks occasionally for exercise. In writing, we will be precise and to the point and fill the paper with content as opposed to words aimed at beating the word count. Include signs, symptoms, and risk factors. Pharynx is nonerythematous and without exudate. EOMs intact. Use this week's iHuman case titled "Jack Baldwin VE" and create a SOAP note with a treatment plan (located at the bottom of the SOAP note. Describe the course of the patients illness, including when it began, character of symptoms, location where the symptoms began, aggravating or alleviating factors; pertinent positives and negatives, other related diseases, past illnesses, surgeries or past diagnostic testing related to present illness. Chronic Illnesses/Major traumas:Patient has a significant history for hypertensionChronic Health Problems: Immunizations:Up to date on all immunizations. Capillary refill 2 seconds. Use this week's iHuman case titled "Jack Baldwin VE" and create a SOAP note with a treatment plan (located at the bottom of the SOAP note. Provide a reference for your treatment plan (in APA format). Please note that your SOAP note has several areas that have required information. Our writers have strong academic backgrounds with regards to their areas of writing. Oral mucosa pink and moist. External genitalia reveals coarse pubic hair in normal distribution; skin color is consistent with general pigmentation. This is one of the areas where nursing writing services like ours can help. Register . Ears: Canals patent. Complains of sharp, burning pain to the area. Advise that a person sho has never had chicken pox may contract chicken pos by exposure to the shingles rash. Complains fo generalized malaise. Medications: Lisinopril 10mg by mouth daily, Chronic Illness/Major Traumas: Hypertension I10 (ICD-10 Code Lookup, 2016), Kidney stone 20.0 (ICD-10 Code Lookup, 2016), Father: Hypertension, CAD, prostate cancer, Social History Marital status/personal support system: Married x 20 years without kid. No thyromegaly or nodules. [South University]. Otherwise no complaints at this time. The third result is Jack Lee Baldwin age 60s in El Cajon, CA in the El Cajon neighborhood. Eyes: PERRLA. Hernia inguinal K40 (ICD-10 Code Lookup, 2016). Capillary refill 2 seconds. Thepain should ease within two to three days. If you are short of Budget, contact our Live Support for a Discount Code. We are always waiting to answer all your questions. Anyone diagnosed with: lung disease, heart disease, htn, cancer, TB, DM, or kidney disease. Explore. Reports pain and rash on the right side of back. Are you looking for custom essay writing service or even dissertation writing services? Denies any heat or cold intolerance, thyroid enlargement or tenderness, unexpected weight changes, or abnormal distribution in body hair. No thyromegaly or nodules. Good tone. Cervix is pink. Musculoskeletal: Full ROM seen in all 4 extremities as patient moved about the exam room. Truss can be used to groin hernias. When autocomplete results are available use up and down arrows to review and enter to select. Safety status. Patient states he began to feel a tingling and burning sensation to the area approximately 48 hours age, and then blisters appeared 24 hours ago. EOMs intact. No nail pitting or clubbing. Ears: Canals patent. Get the Solution Attachments Jack_Baldwin.ZIP (18.96 KB) Jack Baldwin V5 i-human Tutorial # 00623469 Posted On: 05/22/2021 11:18 AM Feedback Score: Not rated yet! IHuman - SCOTT BALDWIN (SEIZURE) - NUR 4045 (NUR4045) - Stuvia US. Full ROM seen in all 4 extremities as patient moved about the exam room. Click here for information on how to access and navigate iHuman. Jack Baldwin VE iHuman Episodic SOAP Note, Permalink:https://nursingbay.com/jack-baldwin-ve-agnoses-examples/, Jack Baldwin VE iHuman Episodic SOAP Note and Differential Diagnoses Examples. ORDER COMPREHENSIVE SOLUTION PAPERS ON Jack Baldwin VE iHuman Episodic SOAP Note, https://digitalbookshelf.southuniversity.edu/#/books/9780826168757/, Mean corpuscular hemoglobin concentration (MCHC). Fitness: encouraging increasing exercise (Buttaro, Trybulski & Bailey, 2013). Philadelphia, PA: F.A. Retrieved fromhttps://digitalbookshelf.southuniversity.edu/#/books/9780826168757/. No S3, S4, murmurs, or bruits noted. Jack Baldwin V3 PC (Basic DDx) 50 years 6' 0" 180 pounds Jack Baldwin Chief complaint: Groin pain Start differential diagnosis and final diagnosis . (Rectal as appropriate: no evidence of hemorrhoids, fissures, bleeding or massesMales: prostrate is smooth, non-tender and free from nodules, is of normal size, sphincter tone is firm). Cancer-screening modalities for gender/age: prostate exam (Buttaro, Trybulski & Bailey, 2013). No extra sounds, clicks, rubs or murmurs. Ovaries are non-palpable. Maintains eye contact. Urgency, frequency burning, change in color of urine. Full ROM; no cervical lymphadenopathy; no occipital nodes. Nose: Nasal mucosa pink; normal turbinates. Allergies:NKDAMedication Intolerances:None. No other lesions, bruises, or suspicious moles present. It should be surgical intervention if patient get strangulated hernias (Cash, 2014). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Overwise, PRN. External genitalia reveals coarse pubic hair in normal distribution; skin color is consistent with general pigmentation. He is well-groomed, fit, and cheerful, he is alert and orientedx4, can answer any question by himself.. At the risk of sounding immodest, we must point out that we have an elite team of writers. https://digitalbookshelf.southuniversity.edu/#/books/9780826168757/, Nursing Capstone Project Writing Services, Nursing Annotated Bibliography by Professional, Online Nursing Research Paper writing service, Mean corpuscular hemoglobin concentration (MCHC). Have you every been told that you have: Diabetes, HTN, peptic ulcer disease, asthma, lung disease, heart disease, cancer, TB, thyroid problems or kidney disease or psychiatric diagnosis.. Approximately 7 inches in length. We never resell papers on this site. Tactile fremitus equal bilaterally. Thepain should ease within two to three days. No relevant social history; denies use of tobacco, alcohol, or illicit drugs. Jack Baldwin VE iHuman Episodic SOAP Note and Differential Diagnoses Examples. Contraception, sexual activity, STDS Fe: last pap, breast, mammo, menstrual complaints, vaginal discharge, pregnancy hx;Male: prostate, Sinus problems, dysphagia, nose bleeds or discharge, dental disease, hoarseness, throat pain, Back pain, joint swelling, stiffness or pain, fracture hx, osteoporosis, Syncope, seizures, transient paralysis, weakness, paresthesias, black out spells. One of the questions that should have been asked is the social relationship of the patient. Overwise, PRN. The testicles are normal in size and nontender to palpation. No palpable thrills, lifts, or heaves. The other symptoms include urethral discharge, dysuria, hematuria (Cash, 2014), Kidney Stone: Add Ct scan to determine the stone size, if the test of urine positive for renal calculi. Therefore, any of the symbols found on these symbol pages can be used for historical Daily charts with those Trading services. Genitourinary: Bladder is non-distended; no CVA tenderness. BMI: 24.4 Temp: 99 (Oral)BP: 170/94. No hepatosplenomegaly. Whatever the need may be, our goal is to help students make it to graduation and achieve their dreams. Abdomen obese; BS active in all 4 quadrants. Head is normocephalic, atraumatic and without lesions; hair evenly distributed. Balance stable; gait normal. Skin is brown, warm, dry, clean and intact. Pulses 3+ throughout. Provide a subjective, objective, assessment, and plan (SOAP) note on this patient and your treatment plan using the SOAP note template. Recommend smoking cessation patient not ready (Buttaro, Trybulski & Bailey, 2013). Jack Baldwin VE iHuman Episodic SOAP Note and Differential Diagnoses Examples SOAP Note and Differential Diagnoses for iHuman Case. You would not leave these in an official SOAP note. Table of Content. No extra sounds, clicks, rubs or murmurs. We accept MasterCard, Visa, Amex and Discover. SOAP Note and Differential Diagnoses for iHuman Case. : Mosby/Elsevier. Hence, quality will consistently be at the top. Tenderness is appreciated in the left inguinal canal; the scrotum is swollen on the left side; the testicles are normal in size and nontender to palpation. Complains of rash to middle of right side of back. Eyes: PERRLA. Teeth are in good repair. Thesis papers will only be handled by Masters Degree holders while Dissertations will strictly be handled by PhD holders. Provide a subjective, objective, assessment, and plan (SOAP) note on this patient and your treatment plan using the SOAP note template. Pulses 3+ throughout. Provide a reference for your treatment plan (in APA format). Add or change photo on IMDbPro Add to list Known for Henry IV: Part 1 8.7 Falstaff Uterus is antevert and positioned behind a slightly distended bladder; no fullness, masses, or tenderness. Treatment of kidney stone includes: pain management such as ibuprofen (Motrin, Advil), Zofran 4mg every 6 hours as needed for controlling nausea/vomiting, helping with passing the stone by using Tamsulosin (Flomax) 0.4mg daily to ease urination (Buttaro, Trybulski & Bailey, 2013). Describe the evaluation tool and explain why this tool is essential in the care of the adolescent patient population. On-Time Delivery! Speech is soft, though clear and of normal rate and cadence; answers questions appropriately. Bilateral TMs pearly grey with positive light reflex; landmarks easily visualized. HIV status, bruising, blood transfusion hx, night sweats, swollen glands, increase thirst, increase hunger, cold or heat intolerance, Depression, anxiety, sleeping difficulties, suicidal ideation/attempts, previous dx. 4. Dressed in clean slacks, shirt and coat. We provide you 24*7 help and complete your work before the deadline. Blisters intact, no exudate or crusting present. Maintains eye contact. 4 pages. Pricing and Discounts
Otherwise no complaints at this time. They will write your papers from scratch. (Rectal as appropriate: no evidence of hemorrhoids, fissures, bleeding or massesMales: prostrate is smooth, non-tender and free from nodules, is of normal size, sphincter tone is firm). No septal deviation. When autocomplete results are available use Up and down arrows to review enter. Degree holders while Dissertations will strictly be handled by Masters Degree holders while Dissertations strictly! Use Up and down arrows to review and enter to select * 7 help and complete your work before deadline...: encouraging increasing exercise ( Buttaro, Trybulski & Bailey, 2013 ) Buttaro, Trybulski &,... Social relationship of the symbols found on these symbol pages can be used for historical Daily charts with those services! & Bailey, 2013 ) or tenderness, no dimpling, wrinkling or discoloration of the adolescent population. 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Your treatment plan ( in APA format ) service or even dissertation writing services like ours can.... Should have been asked is the social relationship of the questions that have... Gender/Age: prostate exam ( Buttaro, Trybulski & Bailey, 2013 ) weight,...
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