b’Shool requirements:Turn it in Score must be less than 50%, must be your own work and in your own words,APA format,xc2xa0xc2xa0Copy paste from websites or textbooks will not be accepted or tolerated.xc2xa0Please s’

b’nShool requirements:Turn it in Score must be less than 50%, must be your own work and in your own words,APA format,xc2xa0xc2xa0Copy paste from websites or textbooks will not be accepted or tolerated.xc2xa0Please see College Handbook with reference to Academic Misconduct Statement.Pick any Chronic Disease from Weeks 6-10: you can pick any of this condition,but have to be chonic not acute, cistic fibrosis,influenza,pleural effsuin,pulmonary embolism,tubercolosis,celiac disease,cirrhosis,divertiulitis,hepatitis encephalopathy,,hepatitis,pancreatic cancer,bladder cancer,prostate cancer,bph,prostatitis,cushing disease,addison disease,myasthemia gravis,priapis.ANY OF THAT CONDITIONS,JUST ONE,BUT CHONIC.Sample:SOAP NOTE SAMPLE FORMAT FOR MRCxc2xa0Name: xc2xa0LP Date: Time: 1315 xc2xa0 Age: 30 Sex: F SUBJECTIVE CC: xc2xa0xc2xa0xe2x80x9cI am having vaginal itching and pain in my lower abdomen.xe2x80x9d xc2xa0HPI: xc2xa0xc2xa0Pt is a 30y/o AA female, who is a new patient that has recently moved to Miami. xc2xa0She seeks treatment today after unsuccessful self-treatment of vaginal itching, burning upon urination, and lower abdominal pain. xc2xa0She is concerned for the presence of a vaginal or bladder infection, or an STD. xc2xa0Pt denies fever. xc2xa0She reports the itching and burning with urination has been present for 3 weeks, and the abdominal pain has been intermittent since months ago. xc2xa0Pt has tried OTC products for the itching, including Monistat and Vagisil. xc2xa0She denies any other urinary symptoms, including urgency or frequency. xc2xa0She describes the abdominal pain as either sharp or dull. xc2xa0The pain level goes as high as 8 out of 10 at times. xc2xa0200mg of PO Advil PRN reduces the pain to a 7/10. xc2xa0Pt denies any aggravating factors for the pain. xc2xa0Pt reports that she did start her menstrual cycle this morning, but denies any other discharge other that light bleeding beginning today. xc2xa0Pt denies douching or the use of any vaginal irritants. xc2xa0She reports that she is in a stable sexual relationship, and denies any new sexual partners in the last 90 days. xc2xa0She denies any recent or historic known exposure to STDs. xc2xa0She reports the use of condoms with every coital experience, as well as this being her only form of contraceptive. xc2xa0She reports normal monthly menstrual cycles that last 3-4 days. xc2xa0She reports dysmenorrhea, which she also takes Advil for. xc2xa0She reports her last PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP smear result. xc2xa0Pt denies any hx of pregnancies. xc2xa0Other medical hx includes GERD. xc2xa0She reports that she has an Rx for Protonix, but she does not take it every day. xc2xa0Her family hx includes the presence of DM and HTN. xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0Current Medications: xc2xa0Protonix 40mg PO Daily for GERD MTV OTC PO Daily Advil 200mg OTC PO PRN for pain xc2xa0xc2xa0PMHx: Allergies: xc2xa0xc2xa0xc2xa0NKA & NKDAxc2xa0Medication Intolerances: xc2xa0xc2xa0Denies Chronic Illnesses/Major traumas xc2xa0GERD Hospitalizations/Surgeries : Denies xc2xa0xc2xa0Family History :Father- DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal grandparents without known medical issues; 1 brother and 3 other sisters without known medical issues; No children. xc2xa0xc2xa0Social History:Lives alone. xc2xa0Currently in a stable sexual relationship with one man. xc2xa0Works for DEFACS. xc2xa0Reports occasional alcohol use, but denies tobacco or illicit drug use. xc2xa0xc2xa0ROS General: xc2xa0Denies weight change, fatigue, fever, night sweats Cardiovascular Denies chest pain and edema. Reports rare palpitations that are relieved by drinking water xc2xa0xc2xa0Skin:Denies any wounds, rashes, bruising, bleeding or skin discolorations, any changes in lesions xc2xa0Respiratory Denies cough. Reports dyspnea that accompanies the rare palpitations and is also relieved by drinking water xc2xa0xc2xa0Eyes Denies corrective lenses, blurring, visual changes of any kind xc2xa0Gastrointestinal Abdominal pain (see HPI) and Hx of GERD. xc2xa0Denies N/V/D, constipation, appetite changes xc2xa0xc2xa0Ears Denies Ear pain, hearing loss, ringing in ears xc2xa0Genitourinary/Gynecological Reports burning with urination, but denies frequency or urgency. xc2xa0Contraceptive and STD prevention includes condoms with every coital event. xc2xa0Current stable sexual relationship with one man. xc2xa0Denies known historic or recent STD exposure. Last PAP was 7/2016 and normal. Regular monthly menstrual cycle lasting 3-4 days. xc2xa0xc2xa0xc2xa0Nose/Mouth/Throat Denies sinus problems, dysphagia, nose bleeds or discharge xc2xa0Musculoskeletal Denies back pain, joint swelling, stiffness or painxc2xa0Breast Denies SBENeurological Denies syncope, seizures, paralysis, weakness Heme/Lymph/Endo Denies bruising, night sweats, swollen glandsPsychiatric Denies depression, anxiety, sleeping difficultiesxc2xa0OBJECTIVE Weight xc2xa0xc2xa0140lb xc2xa0xc2xa0xc2xa0xc2xa0 Temp -97.7 BP 123/82 Height xc2xa05xe2x80x994xe2x80x9d Pulse 74Respiration: 18 General Appearance Healthy appearing adult female in no acute distress. Alert and oriented;xc2xa0answers questions appropriately. xc2xa0Skin Skin is normal color for ethnicity, warm, dry, clean and intact. No rashes or lesions noted. HEENT Head is norm cephalic, hair evenly distributed. Neck: Supple. Full ROM. Teeth are in good repair. Cardiovascular S1, S2 with regular rate and rhythm. No extra heart sounds. xc2xa0Respiratory Symmetric chest walls. Respirations regular and easy; lungs clear to auscultation bilaterally. Gastrointestinal Abdomen flat; BS active in all 4 quadrants. Abdomen soft, suprapubic tender. No hepatosplenomegaly. xc2xa0xc2xa0xc2xa0Genitourinary Suprapubic tenderness noted. xc2xa0Skin color normal for ethnicity. xc2xa0Irritation noted at labia majora, minora, and perineum. No ulcerated lesions noted. Lymph nodes not palpable. xc2xa0Vagina pink and moist without lesions. xc2xa0Discharge minimal, thick, dark red, no odor. xc2xa0Cervix pink without lesions. No CMT. Uterus normal size, shape, and consistency. xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0Musculoskeletal Full ROM seen in all 4 extremities as patient moved about the exam room. Neurological xc2xa0Speech clear. Good tone. Posture erect. Balance stable; gait normal. Psychiatric Alert and oriented. Dressed in clean clothes. Maintains eye contact. Answers questions appropriately.xc2xa0Lab Tests Urinalysis xe2x80x93 blood noted (pt. on menstrual period), but results negative for infection Urine culture testing unavailable Wet prep – inconclusive xc2xa0STD testing pending for gonorrhea, chlamydia, syphilis, HIV, HSV 1 & 2, Hep B & C xc2xa0xc2xa0xc2xa0Special Tests- No ordered at this time. xc2xa0xc2xa0xc2xa0Diagnosis xc2xa0xc2xa0Differential Diagnoses :1-Bacterial Vaginosis (N76.0) o2- Malignant neoplasm of female genital organ, unspecified. (C57.9)xc2xa03-Gonococcal infection, unspecified. (A54.9) Diagnosis o Urinary tract infection, site not specified. (N39.0) Candidiasis of vulva and vagina. (B37.3) secondary to presenting symptoms (Colgan & Williams, 2011) & (Hainer & Gibson, 2011). xc2xa0xc2xa0Plan/Therapeutics xe2x80xa2Plan: xc2xa0xc2xa0o Medication : Terconazole cream 1 vaginal application QHS for 7 days for Vulvovaginal Candidiasis; xc2xa0xefx82xa7 Sulfamethoxazole/TMP DS 1 tablet PO twice daily for 3 days for UTI (Woo & Wynne, 2012) o Education xe2x80x93 xc2xa0xefx82xa7Medications prescribed:UTI and Candidiasis symptoms, causes, risks, treatment, prevention. Reasons to seek emergent care, including N/V, fever, or back pain. xc2xa0xc2xa0xefx82xa7 STD risks and preventions. xc2xa0xefx82xa7 Ulcer prevention, including taking Protonix as prescribed, not exceeding the recommended dose limit of NSAIDs, and not taking NSAIDs on an empty stomach. xc2xa0xc2xa0o Follow-up xe2x80x93 xc2xa0xefx82xa7 Pt will be contacted with results of STD studies. xc2xa0xc2xa0xefx82xa7 Return to clinic when finished the period for perform pap-smear or if symptoms do not resolve with prescribed TX. xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0xc2xa0Referencesxc2xa0Colgan, R. & Williams, M. (2011). Diagnosis and Treatment of Acute Uncomplicated Cystitis. American Family Physician, 84(7), 771-776. Hainer, B. & Gibson, M. (2011). Vaginitis: Diagnosis and Treatment. American Family Physician, 83(7), 807-815. xc2xa0Woo, T. M., & Wynne, A. L. (2012). Pharmacotherapeutics for Nurse Practitioner Prescribers (3rd ed.). Philadelphia, PA: F.A. Davis Company. ‘