Your SOAP note should be clear and concise; nurse practitioner students will lose points for improper grammar, punctuation, and misspellings. You must us
November 16, 2024
Your SOAP note should be clear and concise; nurse practitioner 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.
Your submission will be reviewed for plagiarism through Turnitin.
Complete and submit the assignment using the appropriate template in Microsoft Word.
Also, the rubric is provided in the template.Â
SOAPNoteTemplate.docx
SOAP NOTE TEMPLATE
Review the Rubric for more Guidance
Demographics
Chief Complaint (Reason for seeking health care)
History of Present Illness (HPI)
Allergies
Review of Systems (ROS)
General:
HEENT:
Neck:
Lungs:
Cardio
Breast:
GI:
M/F genital:
GU:
Neuro
Musculo:
Activity:
Psychosocial:
Derm:
Nutrition:
Sleep/Rest:
LMP:
STI Hx:
Vital Signs
Labs
Medications
Past Medical History
Past Surgical History
Family History
Social History
Health Maintenance/ Screenings
Physical Examination
General:
HEENT:
Neck:
Lungs:
Cardio
Breast:
GI:
M/F genital:
GU:
Neuro
Musculo:
Activity:
Psychosocial:
Derm:
Diagnosis
Differential Diagnosis
ICD 10 Coding
Pharmacologic treatment plan
Diagnostic/Lab Testing
Education
Anticipatory Guidance
Follow up plan
Prescription
See Below (scroll down)
References
Grammar
Signature (with appropriate credentials):_____________________________________
References (must use current evidence-based guidelines used to guide the care [Mandatory])
EA
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