NR 601 MAT ADLT WEEK 2 SOAP 2
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NR 601 MAT ADLT WEEK 2 SOAP 2
PMH:
Chronic back pain
Hypertension
CARDIOVASCULAR:
RESPIRATORY:
GASTROINTESTINAL: No reports anorexia, nausea, vomiting or
diarrhea or abdominal pain or blood.
GENITOURINARY: No reports of frequency, urgency, burning
NEUROLOGICAL: No headache, dizziness, syncope, paralysis,
ataxia, Reports numbness and tingling in the lower extremities “my
feet just burn and tingle all the time and it is so much worse at night”
No change in bowel or bladder control.
MUSCULOSKELETAL: No muscle, back pain, joint pain or stiffness.
HEMATOLOGIC: No reported anemia, bleeding or bruising.
LYMPHATICS: No enlarged nodes. No history of splenectomy.
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