Q1. Assessment Description

Select one head, eye, or ear condition or disorder. Summarize and discuss the clinical characteristics and identify the appropriate laboratory, imaging, and other diagnostic and screening tools that apply to this condition or disorder. Explain why you selected these tests or tools as being appropriate to this process. Support your summary and recommended plan with a minimum of two APRN-approved scholarly resources.
 

Disorder selected- Diabetic retinopathy 

Q2.Assessment Description

Using the condition you posted about in DQ 1 this week, provide a SOAP note using the format outlined below. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

Subjective

CC (Chief complaint)

HPT (History of present illness)

History (Pertinent medical, surgical, social, medications, exposure, family history, allergies, vaccines)

ROS (Review of systems)

Objective

Vital signs/BMI

Physical exam findings

Diagnostic results (include actual “results” or ©ndings4hat you would expect for a certain scenario)

Assessment/Plan

• Differential list and rationale for final/working diagnosis
• Problem list
• Plan for Each Problem
• Based on evidence with proper references

Further diagnostic testing you would order

Nonpharmacologic therapy

Pharmacologic therapy, including specific medication dose

Frequency and duration of therapy

• Patient education
•  Follow-up