week 4 assign 1 SOAP 6512

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Assignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions

Photo Credit: Getty Images/iStockphoto

Properly identifying the cause and type of a patients skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To Prepare

  • Review the Skin Conditions document provided in this weeks Learning Resources, and select one condition to closely examine for this Lab Assignment.
  • Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
  • Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
  • Consider which of the conditions is most likely to be the correct diagnosis, and why.
  • Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
  • Review the Comprehensive SOAP Exemplar found in this weeks Learning Resources to guide you as you prepare your SOAP note.
  • Download the SOAP Template found in this weeks Learning Resources, and use this template to complete this Lab Assignment.

The Lab Assignment

  • Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
  • Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this weeks Learning Resources.

Learning Resources

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.

Chapter 9, Skin, Hair, and Nails

This chapter reviews the basic anatomy and physiology of skin, hair, and nails. The chapter also describes guidelines for proper skin, hair, and nails assessments.

Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis.
Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center.

This section explains the procedural knowledge needed prior to performing various dermatological procedures.

Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.

Note: Download and use the Student Checklist and the Key Points when you conduct your assessment of the skin, hair, and nails in this Weeks Lab Assignment.

Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.

Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1 and 3)

Shadow Health Support and Orientation Resources

Use the following resources to guide you through your Shadow Health orientation as well as other support resources:

Optional Resources

LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowins diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.

Chapter 6, The Skin and Nails

In this chapter, the authors provide guidelines and procedures to aid in the diagnosis of skin and nail disorders. The chapter supplies descriptions and pictures of common skin and nail conditions.

Module 3 Introduction
Dr. Tara Harris reviews the overall expectations for Module 3. Consider how you will manage your time as you review your media and Learning Resources for your Discussions, Case Study Lab Assignments, DCE Assignments, and your Midterm exam (12m).
Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Skin, Hair, and Nails – Week 4 (19m)

Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript

Online media for Seidel’s Guide to Physical Examination

In addition to this week’s media, it is highly recommended that you access and view the online resources included with the text, Seidel’s Guide to Physical Examination. Focus on the videos and animations in Chapter 8 that relate to the assessment of the skin, hair, and nails.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at

To Register to View the Content

  1. Go to
  2. Enter the name of the textbook, Seidel’s Guide to Physical Examination (name of text without the edition number) in the Search textbox.
  3. Complete the registration process.

To View the Content for this Text

  1. Go to
  2. Click on Student Site.
  3. Type in your username and password.
  4. Click on the Login button.
  5. Click on the plus sign icon for Resources on the left side of the screen.
  6. Click on the name of the textbook for this course.
  7. Expand the menu on the left to locate all the chapters.
  8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Suturing Tutorials

The following suturing tutorials provide instruction on the basic interrupted suture, as well as the vertical and horizontal mattress suturing techniques

Incision and Drainage of an Abscess (a common procedure in primary care)

Dermablade Use for Shave Biopsies

Welcome to week 4

We are entering week 4. Students have 2 assignments due this week. You will choose a lesion to document the SOAP note and secondly, this week is our first Shadow Health Assignment. There are several student tips, how to upload the lab pass, etc. located in the course.  Regarding the SOAP notes, there is not enough information. I advise you to make up the information that is not there (ie. Health hx, social hx, etc). This will allow you to critically think as you develop the notes.

  You need to know that the DCE score is not the only score that counts as your grade, it is only a portion of the grade. You must complete the documentation portion. Also, we have noted that in SH, the ROS is not located in the documentation portion but is located in the subjective data collection portion.  Remember to document as the SOAP order. I advise you to review my SOAP document send last week for guidance.

Last week we engulfed in great conversation on the risks of our findings about growth, measurements, and nutrition of children and their families. As practitioners, its important to communicate professionally, ask the right questions, and guide families as they strive to have healthier and happy lives. This week we will begin to review assessments of body systems. Skin, Hair, and Nails will be covered. I encourage you to perform the assessment of Skin, Hair, and Nails so that you may be proficient with it for the overall assessment. You are able to access the check lists by enrolling into the evolve website in your resources. 

You first assignment for this week is to be written in a SOAP Note format (NO NARRATIVES). There is a template/sample for you to follow posted in your announcements at the beginning of the semester. You will need to put in the missing information in the note (some may be made up ie meds, hx, parts of the ROS and PE).  In the Assessment/Plan, you will document your differential diagnoses as per the assignment. I will comment on your notes and if needed, send you an email if I need to help you with them more.

Assignment 1:

The Lab Assignment

Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.

 Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this weeks Learning Resources.