Acute Bacterial Pharyngitis

Discusion topic: SOAP note about

Requirements

· The discussion must address the topic

· Rationale must be provided

· Use at least 600 words (no included 1st page or references in the 600 words)

· May use examples from your nursing practice

· Formatted and cited in current APA 7

· Use 3 academic sources, not older than 5 years. Not Websites are allowed.

· Plagiarism is NOT permitted

Demographic Information:

Encounter Date:

Patient initials:

Age:

Race:

Gender:

Insurance:

Information Source:

SUBJECTIVE

Chief complaint:

History of present illness (HPI):

Allergies:

Medication History:

Family History:

Past medical History (PMH)

Immunization status:

Developmental stage:

Hospitalization:

History of mental illness/personality disorders:

Physical trauma/falls:

Surgeries:

Exercise:

Diet:

Social History:

Last annual physical exam:

REVIEW OF SYSTEMS:

Systemic:

HEENT:

Head:

Neck:

Cardiovascular:

Respiratory:

Gastrointestinal:

Genitourinary:

Musculoskeletal:

Neurological:

Mental:

Integumentary:

OBJECTIVE:

Physical Exam

Vitals Signs:

General appearance:

Skin:

Lymph nodes

HEENT:

Head:

Face:

Eyes:

Ears:

Nose:

Mouth:

Throat

Neck

Chest/Lungs

Cardiovascular:

Abdomen:

Genitals/Urinary:

Musculoskeletal

Neurologic

ASSESSMENT

Diagnosis

Differential diagnosis

PLAN

labs /Diagnostic test ordered

Pharmacological treatment:

Non-pharmacological measures:

Education:

Referral/Follow up:

References