Please use SOAP note format and all resources must be journal articles or reputable sources and utilize APA 7th edition format
Please use SOAP note format and all resources must be journal articles or reputable sources and utilize APA 7th edition format, please! I do not have complete assignment instructions and rubric because we have to wait until she grades the last one before gaining access to the next module. Thank you!
Abdomen:
- Inspect the skin and contour of the abdomen
- Observe for peristalsis and pulsations
- Auscultate the abdomen
- Auscultate for bruits over the aorta, renal arteries, iliac arteries and femoral arteries
- Percuss the abdomen
- Palpate the abdomen (light then deep)
- Assess for peritoneal inflammation
- Rebound tenderness
- Murphy’s sign
- Rovsing’s sign
- Psoas sign
- Obturator sign
- Cutaneous hyperesthesia
- Percuss liver
- Palpate liver
- Percuss spleen
- Palpate spleen
- Palpate bilateral kidneys
- Assess for CVA tenderness
- Palpate width of the aorta
Nervous system
- Assess mental status
- Cranial nerves 1-12
- Motor system: muscle bulk, tone strength, coordination, gait, and stance
- Sensory system: pain/temp, vibration, light touch, discrimination
- Deep tendon reflexes
Next, you will need to document your findings.
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