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Tina jones shadow health hx docx

Tina jones shadow health hx docx

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chamberlain school of nursing

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SOAP note Template for Shadow Health Identifying Information:Tina Jones, 28 year old, African American Female. Information given by patient. Reports private insurance through her employer. Here in the office by herself states her mother dropped her off. Patient appears to be a reliable historian . Subjective (S) Chief Complaint (CC): Ms. Jones claims “I got this scrape on my foot a while ago and thought it would heal up on its own, but it’s looking pretty nasty” HPI: is ar stu ed d vi y re aC s o ou urc rs e eH w er as o. co m Tina reports she scraped her right foot on the edge of a cement step a week ago. Over the last few days Tina reports her pain has intensified and she currently rates her pain 7/10 on a 0-10 scale with 10 being the worst. Patient states the pain is throbbing and sharp, which makes it difficult for her to bear weight on it. Patient states that when she does bear weight the pain shoots up her leg. Patient was seen in the emergency department after the incident initially took place. While in the ED patient was given a prescription for Tramadol that she is currently taking for the foot pain. Past Medical History: Diabetes, Asthma Past Surgical History: No ...
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