Question Description
***Progress Note included in Instructions**
***Grading Rubric must be followed***
APA Format for references
ALL 15 MUST BE COMPLETED
Instructions
Review the progress note below, including the subjective and objective notations.Complete the skin progrss note attachment
- Select 15 medical terms from the progress note.
- Translate the 15 selected medical terms into commonly used terms.
- Spell the 15 medical and common terms correctly.
- Cite in correct APA style the references you used to perform your translation. Click APA Style and Format for additional guidance on how to ensure your citations and references conform to APA guidelines.
Skin Progress Note
Subjective: The patient is a 49-year-old female who comes in with the complaint of having bumps on her arms. She states some of the bumps have been there a long time. Recently the bumps have been increasing in number and size. She was last seen about two years ago for eczema, at which time she did not have these bumps. The bumps are not itchy or painful.
Objective: Very pleasant, alert, and oriented x3 female in no apparent distress. A full integumentary exam of the upper extremities was performed today. The left radial aspect demonstrated erythematous macules. The right ulnar aspect demonstrated actinic keratosis. Bilateral hands appeared dry with linear excoriation and fissuring of her fingertips. Bilateral upper arms demonstrated superficial and deep masses. Deep subcutaneous masses are mobile and may represent lipomas. Superficial masses appear to be sebaceous cysts.
Assessment and Plan:
- Actinic keratosis of the right ulnar aspect was treated with liquid nitrogen.
- Possible lipomas: Schedule surgical biopsy of larger masses.
- Sebaceous cysts: Punch biopsy performed today; await pathology report. Apply Neosporin to biopsy site.
- Continue Cortisone 10 intensive cream for eczema.
Additional Requirements
- Format: Ensure you complete all columns on the Skin Progress Note Template.
- Scoring Guide: Be sure to read the scoring guide for this assessment, so you understand how your faculty member will evaluate your work.
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