Use five medical words discussed in this week’s reading to create a SOAP note.
Here are the words. You put them together.
http://kidshealth.org/kid/word/
how can i create a soap using medical word
Writing a SOAP (Subjective, Objective, Assessment, Plan) note is a standard manner of documenting patient encounters in medical settings. To create a SOAP note, we need to include five medical words from the reading. However, as an AI language model, I don't have access to specific readings. Instead, I can provide you with an example of a SOAP note using five common medical words. Here's an example:
Subjective:
The patient, a 45-year-old male, complains of severe abdominal pain, which started three days ago. He rates the pain as 8 out of 10 and describes it as sharp and constant. Additionally, he reports having nausea and occasional vomiting.
Objective:
Upon physical examination, the patient's abdomen is tender to palpation in the upper right quadrant. Blood pressure is within normal range, heart rate is slightly elevated at 100 beats per minute, and body temperature is 37.8°C (100°F).
Assessment:
Based on the patient's symptoms and physical examination findings, the indicative diagnosis is acute cholecystitis.
Plan:
1. Order an abdominal ultrasound to confirm the diagnosis and evaluate the severity.
2. Recommend NPO (nothing by mouth) for the patient to rest the gallbladder.
3. Administer intravenous fluids to maintain hydration.
4. Prescribe analgesics to manage pain.
5. Consult a surgeon for further evaluation and to consider the possibility of laparoscopic cholecystectomy.
Please note that this is just an example, and a complete SOAP note would typically include more details. When creating a SOAP note, it's essential to gather information from the patient (subjective), conduct a physical examination (objective), form an assessment based on findings (assessment), and lay out the plan of action (plan) for further diagnosis and treatment. Use appropriate medical terminology related to the patient's condition.