Please make the following changes that ive stated below to the clinical judgemen

Please make the following changes that ive stated below to the clinical judgement plan rough draft.
Change up the basic info to another: name age etc
HPI: more detailed (what happened before, during ER, and what’s gonna happen after the ER) what floor patient is going to, what type of dr. Make it more a summary
Lab values: make sure to show triponent (for heart issues)
Medical history: only keep hypertension and diabetes and for pathophysio. Take off meds that’s aren’t associated w new medical history
Surgical history: explain cardiac catheterization
Social history: only talk about Alc, substance and drug use
Socioeconomic: family religion healthcare. Each one is a sentence total paragraph.
Give definition for something vs
Try to keep like labs togwther
Grouo cardiac and lipid
Be more detailed about abnormal values
Add chest x Rey, Ecco, EKG
Gebrtubity vs stagnant
Patient education : where is it going after discharge (does he need oxygen?)
Give time frame of when he will see cardiologist in the office
What’s their learning style? Audio, vision,
Any barriers? (Hearing aid, blind)
Write pathophysio for myocardial infarction
Med list:
Add MONA (morphine, oxygen, nitroglycerin, aspirin) to the HPI section
Morphine, oxugeb. nitro, then aspirin (for pt w cardisx)
3 medicstion consideration for each sectjon
be specific about vital signs
Add MONA (morphine, oxygen, nitroglycerin, aspirin) for planning and be more specific in implementation

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