PATIENT INFORMATION Name: Part of the Soap note (Assessment and plan) with OSTEO

PATIENT INFORMATION
Name: Part of the Soap note (Assessment and plan) with OSTEOARTHRITIS
WORK IN ASSESSMENT AND THE FOLLOWING:
– Main Diagnosis OSTEOARTHRITIS
For the main diagnoses provide a cited rationale for choosing this diagnosis. This rationale includes a one sentence cited definition of the diagnosis (es) the pathophysiology, the common signs and symptoms, the patients presenting signs and symptoms and the findings and tests results that support the dx. Include the interpretation of all lab data given in the case study and explain how those results support your chosen diagnosis.
Must include a Minimum of 3 differential diagnosis with ICD10 codes and a paragraph for each diagnosis that includes a definition of the differential diagnosis, common signs and symptoms, tests results and citations. 1 Main Diagnoses Minimum 3 differential diagnosis.
P: PLAN (this is your treatment plan specific to this patient). Each step of your plan must include an EBP citation. (in-text citation)
1. Medications write out the prescription including dispensing information and provide EBP to support ordering each medication. Be sure to include both prescription and OTC medications.
2. Additional diagnostic tests include EBP citations to support ordering additional tests
3. Education this is part of the chart and should be brief, this is not a patient education sheet and needs
to have a reference.
4. Referrals include citations to support a referral
5. Follow up. Patient follow-up should be specified with time or circumstances of return. You must provide a reference for your decision on when to follow up.
6. References: Notes must have Minimum of 3 Scholarly References ( Journals, Books, and Studies)