Neida CaroboonetranscriptionAdvanced ReportNeurology TE ^N4

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Valencia College *

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1611C

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Medicine

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Dec 6, 2023

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Neida Caro-Boone Neurology TE #4 Neurology SOAP Note: Autism SUBJECTIVE, OBJECTIVE, ASSESSMENT, PLAN (SOAP) Patient Name: Carmen Jean Lopes PCP: Dr. Sandra Peebles, MD Patient ID: LOP165 DOB: 06/01/---- Age: 7 Sex: F Date of Visit: 08/05/-- Problem #1: Rectal Warts. SUBJECTIVE: Patient is here for consent forms to be filled out and to discuss some other issues; but Mom and Dad’s primary concern is that when washing her in the last few weeks, they have noticed some skin tag like lesions near the rectum and want them checked. She has not scratched or irritated them. No previous history. Mom and Dad both do report they get warts on their hands from time to time and do not wear gloves when they wash Carmen Jean. OBJECTIVE: The patient is in her usual semi agitated mode. She is calmer with her father. She certainly interacts well with both parents. Skin is warm and dry to touch. Respiration is full and adequate. No vitals were done. Skin: Rectal area, no redness or edema but there are definitely 5 or 6 or even 8 wart like lesions in various sizes surrounding the anus. They do have cream on them, so it is a little hard to give it a description. Dr. Peebles examined as well and verified. ASSESSMENT: Warts, most likely viral in nature. PLAN: I had a lengthy discussion with mom and dad regarding etiology, caring for them, hygiene issues, etc. We will try Aldara as directed. Dr. Peebles suggested a RPR when she has some upcoming blood work, and we will get that done. There is no concern in Dr. Peebles or my opinion that anyone could get near her in a sexual way, as she would kick and fight and scream. Her parent’s actually initiated that comment. Recheck pending progress, and they will call in a few weeks to tell me how things are going. Problem #1: Autism and Seizure Disorder . SUBJECTIVE: Carmen Jean continues to live with a supportive staff. I believe she is at home at this point. I did not clarify that, but that is the sense I get in the way care taking was described. Mom and Dad are very SUBJECTIVE, OBJECTIVE, ASSESSMENT, PLAN (SOAP)
Patient Name: Carmen Jean Lopes Patient ID: LOP165 Date of Visit: 08/05/-- Page 2 involved in her health care, physical, and daily care. She is learning to respond “yes” and “no” on an I touch phone. They just bought an iPad to try to help with that communication. A big concern on both parent’s part is that the neurologist is thinking of stopping the Dilantin and switching to a different seizure medicine, as there has been some concern that Carmen Jean is having some breakthrough minor seizures when she is tired and agitated. No one is 100% sure that is what is going on. Mom is very hesitant to change the medication, but there is a plan in process if they do switch; the decision has not been made yet. OBJECTIVE: Carmen Jean is as Carmen Jean always is. ASSESSMENT: 1. Severe Autistic Disorder. 2. History of significant seizure disorder. PLAN: Consulted with parents for 25 minutes today, discussing all of the above issues. They need to do what is best for them, best for Carmen Jean, and at the advice of someone they trust. They are working with a neurologist whom they trust and will recheck PRN. ________________________ Greg Farrow, FNP GF:ncb D:08/05/---- T:08/05/---- C:Dr. Sandra Peebles, MD, Internal Medicine Dr. Wanda P. Dale, MD, Neurology
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