b’To do a comment to the post below in APA style with citation, needs 2 credible reference from 2013 and above.Episodic/Focused SOAP Note TemplatePatient Information:J, 11, Male, XX (Race)xc2xa0S.CC: xc2x93Mil’

b”nTo do a comment to the post below in APA style with citation, needs 2 credible reference from 2013 and above.Episodic/Focused SOAP Note TemplatePatient Information:J, 11, Male, XX (Race)xc2xa0S.CC: xe2x80x9cMild ear achexe2x80x9dHPI: The patient is 11 year old XX male who presented himself with a mild right ear ache, which started two days ago. Associated symptom include possible fever, right ear pain, difficulty hearing from the right ear. Associated symptom are exacerbated with sleep.xc2xa0Current Medications: Inquire if patient is currently taking any medications, rule out earring loss related to medication toxicity.xc2xa0Allergies: Inquire about allergies.xc2xa0PMH: Inquire if patient has a history of acute otitis media or underlying hearing loss. Inquire if patient has had tonsillectomy or an adenoidectomy in the past. SH: Spends time in pool during summer.xc2xa0FH: Inquire if family members have history of hearing loss.xc2xa0ROS:GENERAL: Possible fever. Inquire about patientxe2x80x99s swimming habits and ask if ear plugs used. Determine method of cleaning ear.xc2xa0 HEENT: Right ear pain. Inquire if patient has tinnitus, discharge from ear, vertigo, or itchiness. Inquire if patient has a history of acute otitis media, hearing loss, vertigo, tinnitus, discharge from ear canal. RESPIRATORY: Inquire if patient has had post nasal discharge or sputum production and ask about color of mucous.xc2xa0 ALLERGIES: xc2xa0Unknownxc2xa0O.Physical exam:HEENTxe2x80x94 Assess outer ear and note surrounding tissue, shape, color, and any lesions. Assess the external ear for discharge or any odor. Assess for the placement of a foreign object in ear. Assess for tenderness on the outer ear near the auricle and mastoid. Tenderness could indicate a possible infection. Use otoscope to assess external and middle ear. At this time, assess for erythema, lesions, and discharge. Inspect tympanic membrane for perforations. Assess the frontal and maxillary sinuses for swelling. No tenderness or swelling over the soft tissue should be present. Assess tonsils and inside of mouth for lesions, erythema, and swelling.xc2xa0 RESPIRATORY: Determine if upper respiratory infection is present, assess for clear lungs.xc2xa0Diagnostic results:xc2xa0Whispered Voice- Determines if patient is able to hear whispering. If they do not pass this test, hearing loss could be assumed. (Ball, Dains, Flynn, Solomon, Stewart, et al., 2015, p. 241).xc2xa0 Weber Test- Determines unilateral hearing loss (Ball et al., 2015, p. 241).xc2xa0 Rinne Test- Determines if the patient conducts sound better through bone or air. The patient should hear the sound conducted through the air twice as long (Ball et al., 2015, p. 241) Culture of ear fluid (Attlmayr, 2015).xc2xa0Differential DiagnosesOtitis externaxc2xa0 Often seen with individuals that swim. This infection is located on the outer ear. Pain is worse when an otoscope is inserted because sensitivity is on the outer ear. The outer portion of the ear is often inlamted and tender to touch. When inspecting the ear, the ear canal would appear narrow. Because of the narrowing, fluid is unable to drain from the ear (Rosenfeld et al., 2014).xc2xa0 Otitis media Otitis media is a middle ear infection that usually presents unilaterally, hearing loss is present, and tympanic membrane is pink. Pus often forms inside the ear, which could cause perforation of the tympanic membrane. Ear pain, fever, difficulty hearing, irritability, and lethargy can also accompany this diagnosis. While examining the ear with the otoscope, erythema, dullness, decrease light reflex, and bulging of the tympanic membrane (Nash, 2013).xc2xa0 Eustachian catarrhxc2xa0 Often results after an upper respiratory infection. It would be essential to determine if the patient has has a recent upper respiratory tract infection. Fluid collects in the eustachian tube, which causes pain and trouble hearing (Nash, 2013).xc2xa0 Cholesteatomaxc2xa0 The growth of a skin tag inside the ear, behind the ear drum. The patient could be born with it or it can develop after several ear infections. It would be essential to determine if the patient has had frequent ear infections in the past (Chawla, Ezhil Bosco, Lim, Shenoy, & Krishnan, 2015).xc2xa0 Mastoiditis Mastoiditis is a common complication of acute otitis media. Pain, erythema, and tenderness are typically present alone the mastoid process (Attlmayr, 2015).xc2xa0 P.xc2xa0xc2xa0NAReferenceAttlmayr, B., Zaman, S., Scott, J., Derbyshire, S. G., Clarke, R. W., & De, S. (2015).xc2xa0Paediatric acute mastoiditis, then and xc2xa0xc2xa0now: Is it more of a problem now?. The Journalxc2xa0Of Laryngology And Otology, 129(10), 955-959. doi:10.1017/S0022215115002078Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., xc2xa0 Stewart, R. W. (2015). Seidel’s guide to physicalxc2xa0examination (8th ed.). St. Louis, MO: Elsevier Mosby.Chawla, A., Ezhil Bosco, J. I., Lim, T. C., Shenoy, J. N., & Krishnan, V. (2015). Computed tomographyxc2xa0features of external auditory canal cholesteatoma: A pictorial review. Current Problems Inxc2xa0Diagnostic Radiology, 44(6), 511-516. doi:10.1067/j.cpradiol.2015.05.001Nash, L. (2013). A case study on prescribing for an acute ear infection in a child. Nurse Prescribing,xc2xa011(4), 179-184.Rosenfeld, R. M., Schwartz, S. R., Cannon, C. R., Roland, P. S., Simon, G. R., Kumar, K. A., & …xc2xa0Robertson, P. J. (2014). Clinical practice guideline: Acute otitis externa. Otolaryngology-Head &xc2xa0Neck Surgery, 150S1-S24. doi:10.1177/0194599813517083 “