ASSIGNMENT 2: EPISODIC VISIT: COMMON GYNECOLOGIC 1
Assignment 2: Episodic Visit: Common Gynecologic Health Conditions Focused Note
Student Name
Walden University
PRAC - 6552C Advanced Nurse Practice in Reproductive Health Care Practicum
Dr. Ortiz
Date
, ASSIGNMENT 2: EPISODIC VISIT: COMMON GYNECOLOGIC 2
Assignment 2: Episodic Visit: Common Gynecologic Health Conditions Focused Note
Episodic/Focused SOAP Note
Patient Information:
TS, 57 year-old AA Female
S.
CC (chief complaint): Brown vaginal discharge for several days last week.
HPI: This is a 57-year-old nullipara post-menopausal African American female who
reported to the clinic for a one-week history of brown vaginal discharge. She had
noticed occasional spotting on her underwear for the past year, but she did not think
anything about it. She has a significant family history with her mother passing from
“some female cancer,” her sister has breast cancer, and her brother died from colon
cancer. She could not conceive, has been up to date with her mammogram and pap
smear two years ago, both of which have been negative with a NILM HPV negative,
atrophic changes, no endocervical cells. Her colonoscopy result from last year was also
negative. Her diabetes is controlled with oral medications. She denies any pain.
Current Medications:
Metformin 500 mg Oral BID
Assignment 2: Episodic Visit: Common Gynecologic Health Conditions Focused Note
Student Name
Walden University
PRAC - 6552C Advanced Nurse Practice in Reproductive Health Care Practicum
Dr. Ortiz
Date
, ASSIGNMENT 2: EPISODIC VISIT: COMMON GYNECOLOGIC 2
Assignment 2: Episodic Visit: Common Gynecologic Health Conditions Focused Note
Episodic/Focused SOAP Note
Patient Information:
TS, 57 year-old AA Female
S.
CC (chief complaint): Brown vaginal discharge for several days last week.
HPI: This is a 57-year-old nullipara post-menopausal African American female who
reported to the clinic for a one-week history of brown vaginal discharge. She had
noticed occasional spotting on her underwear for the past year, but she did not think
anything about it. She has a significant family history with her mother passing from
“some female cancer,” her sister has breast cancer, and her brother died from colon
cancer. She could not conceive, has been up to date with her mammogram and pap
smear two years ago, both of which have been negative with a NILM HPV negative,
atrophic changes, no endocervical cells. Her colonoscopy result from last year was also
negative. Her diabetes is controlled with oral medications. She denies any pain.
Current Medications:
Metformin 500 mg Oral BID
