A 9-year old female presents with her mother complaining of a dry cough that “wakes up everyone in the house” each night for the last 2 weeks. Denies prior hx of the same.
For the case you have chosen, post to the discussion:
Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed.
In SOAP format, list:
Pertinent positive and negative information
Differential and working diagnosis
Treatment plan, including: pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.
Use at least one scholarly source other than your textbook to connect your response to national guidelines and evidence-based research in support of your ideas.
S- Subjective ( what the patient says)
O- Objective ( your assessment data)
A- Assessment ( Your working and differential diagnosis)
P- Plan (your next step-orders-education- USES Clincial Recommendations/References)
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