Advanced Health Assessment Case study

Assignment Details:

• Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. (Please create additional patient information).

With regard to the case study, you were assigned:

• Review this week’s Learning Resources and consider the insights they provide about the case study.
• Consider what history would be necessary to collect from the patient in the case study you were assigned.
• Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
• Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each. 

Please review the grading rubric before submitting your assignment

CASE STUDY 2: Numbness and Pain (Students in Group C)

A 47-year-old obese female complains of pain in her right wrist, with tingling and numbness in the thumb and index and middle fingers for the past 2 weeks. She has been frustrated because the pain causes her to drop her hair-styling tools.         

SAMPLE SOLUTION

Episodic/Focused SOAP Note Template

Patient Information:
Initials: M.K. Age: 47 Sex: Female Race: African American
S.
CC (chief complaint): I feel pain in my right wrist, and I have been experiencing numbness and tingling in the index, thumb, and middle fingers, and she has difficulty holding curling iron while at work.
HPI: A 47-years-old African American Female comes to the hospital complaining about pain on her wrist, and she has tingling and numbness in the middle, index, and thumb figures for the last two weeks. The pain affects her ability to do work in her daily routine of curling iron and keeps dropping her hair styling tools.
Location: wrist
Onset: 2 weeks ago
Character: she experiences numbness and pain in her arm. tingling, numbness, and pain in the middle finger, thumb finger, index finger, and thumb.
Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia…