see attached. 

I filled in the information obtained in the lab. 

Need assessment and plan sections- i placed * next to things that need to be included.

This assignment will demonstrate your ability to provide age-appropriate anticipatory guidance while recognizing the need to refer patients that are outside of the scope of practice of the family nurse practitioner. This will be demonstrated by completing a SOAP note based on the patient Desiree Allen seen in Unit 2 in the VR platform.


The SOAP note serves several purposes:

1. It is an important reference document that provides concise information about a patient’s history and exam findings at the time of patient visit.

2. It outlines a plan for addressing the issues which prompted the office visit. This information should be presented logically and prominently features all of the data that’s immediately relevant to the patient’s condition.

3. It is a means of communicating information to all providers involved in the care of a particular patient.

4. It allows the NP student to demonstrate their ability to accumulate historical and examination-based information, use their medical knowledge, and derive a logical plan of care.

Knowing what to include and what to leave out will largely depend on experience and your understanding of illness and pathophysiology. If, for example, you were unaware that chest pain is commonly associated with coronary artery disease, you would be unlikely to mention other coronary risk factors when writing the history. As you gain experience, your write-ups will become increasingly focused. You can accelerate the process by actively seeking feedback about all the SOAP notes you create and reading those written by more experienced practitioners.

The core aspects of the SOAP note are described in detail below.

For ease of learning, a 
SOAP note template has been provided. This assignment requires proper citation and referencing because it is an academic paper. 

S: Subjective information. Everything the patient tells you. This includes several areas, including the chief complaint (CC), the history of present illness (HPI), medical history, surgical history, family history, social history, medications, allergies, and other information gathered from the patient. A commonly used mnemonic to explore the core elements of the history of present illness (HPI) is OLD CARTS, which includes: Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatments, and Severity.

O: Objective is what you see, hear, feel or smell. Your physical exam, including vital signs.

A: Assessment/your differentials

P: Plan of care including health promotion and disease prevention for the patient related to their age and gender.

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Rubric Title: Unit 2, 4, 6 Lab – Virtual Reality Rubric

***Students: It is IMPORTANT to remember to utilize both the “Guided Mode” and “Expert Mode” in the VR Lab Simulation case scenario experiences, as you practice the VR Lab scenario(s). The “Guided Mode” and “Expert Mode” allow you to have multiple tries/attempts to practice the case. THEN, when you feel you are ready, you will choose the VR Lab “Exam Mode” (that you can ONLY attempt once); the score you receive in “Exam Mode” will then be your final grade in the VR Lab. If you have any questions regarding this, please follow up with your course instructor.

Assignment Criteria

Level III

Level II

Level I

Not Present

Criteria 1

Level III

Points: 80

Level II

Points: 64

Level I

Points: 48

Not Present

0 Points

Total Score

· Within Exam Mode, obtains 65 to 80 points of the required total components for virtual reality patient scenario

· Within Exam Mode, obtains between 49 to 64.9 points of the required total components for virtual reality patient scenario

· Within Exam Mode, obtains between 33 to 48.9 points of the required total components for virtual reality patient scenario

· Does not attempt in Exam Mode

· Does not meet the criteria

Rubric Title: Unit 3, 5, 7 Journal Assignment Rubric

Criteria 1

Level III Max Points

Points: 6

Level II Max Points

Points: 4.8

Level I Max Points

Points: 4.2

0 Points

Content Quality- Subjective Data

Subjective data displays complete understanding of all critical concepts of virtual reality patient case including:

· Name, age, gender

· Chief complaint

· History of present illness (HPI) that follows OLD CARTS pneumonic

· Medications

· Allergies

· Past medical history

· Past surgical history

· Pertinent family history

· Social history

· Review of Systems

· Subjective data displays understandi

Name:  Desiree J. Allen
DOB 5/4/92

 Pt. Encounter Number:2

Date: 1/17/23

Age: 29

Sex: F



“Heavy periods”



29 yo G1P1 Caucasian female, history of incomplete L2 spinal cord injury resulting in paraplegia. History of heavy flow since onset of menses and presence of symptoms for one quarter of her life, now soaking super absorbency pad every 3 hours. Menses lasts one week or more. Reports flow is lighter for a couple days leading up and few days at the end however 5-6 days of heavy flow. Associated symptoms include lower abdominal pain, headache, body aches, fatigue and digestive issues including nausea and bloating. Has been seen by physician in past. Work up included Transvaginal ultrasound last year, results normal and endometrial biopsy normal. Was prescribed progestin-only pill but had difficulty with medication compliance. Has tried increased water intake, rest, healthier eating and PRN Midol use with no improvement. Has not identified any pattern to worsening symptoms. Describes symptoms as intense, unmanageable, pain severity 8/10. Unable to use tampons due to limited mobility and seeking alternate method to shorten and lighten menstrual flow.


Flexeril 10mg TID PRN for muscle spasm

Ibuprofen 600mg PRN generalized pain




Medication Intolerances: none reported

Past Medical History: Incomplete spinal cord injury L2 x 1 year, menorrhagia


Chronic Illnesses/Major traumas Spinal cord injury 1 year ago due to MVA resulting in paraplegia, patient is wheelchair bound.


Hospitalizations/Surgeries Spinal cord decompression 2022 following MVA, hospitalized x 3 weeks followed by 30 stay inpatient rehab.

Term pregnancy (40 weeks) with normal spontaneous vaginal delivery 4 years ago

Preventative Health: Normal PAP one year ago. COVID UTD. TDAP 2 years ago.



Family History



Father- HTN


Social History

Pronouns used -she, her, hers. Completed 4-year degree in telecommunications. Currently unemployed and