| Course | DNP 605 Advanced Health Assessment Across Lifespan |
|---|---|
| Module | Module 7 |
| Paper type | Episodic SOAP note, geriatric |
| Length | About 663 words, 5 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | DNP |
| Updated | October 2026 |
Free sample paper for DNP 605 Module 7
A New Headache at Seventy-Nine: An Episodic SOAP Note for Suspected Giant Cell Arteritis
Student Name
Edson College of Nursing and Health Innovation, Arizona State University
DNP 605: Advanced Health Assessment Across Lifespan
Instructor Name
Month Day, Year
A New Headache at Seventy-Nine: An Episodic SOAP Note for Suspected Giant Cell Arteritis
Subjective
Chief concern: "This headache on my right side just won't quit."
HPI: Mrs. E., 79, reports a new headache over the right temple for two weeks, constant, aching, 6 of 10, worse at night, not relieved by acetaminophen. She never had headaches before. Her scalp is tender when she brushes her hair. Her jaw aches after chewing for a few minutes and eases with rest. Three days ago, vision in her right eye blurred for about five minutes and then cleared. She has felt tired, has had a low appetite and has lost about 5 pounds in a month. For several weeks her shoulders and hips have been stiff for over an hour each morning.
Pertinent negatives: No fever over 100.4 °F, no trauma, no weakness, numbness or speech change, no double vision, no neck stiffness, no rash.
PMH: Hypertension, osteoarthritis of the knees, osteopenia.
Medications: Losartan 50 mg daily; acetaminophen as needed; calcium and vitamin D.
Allergies: Sulfa (rash).
Social history: Widowed, lives alone, independent in daily activities; daughter nearby. Never smoked; rare alcohol. Drives.
Family history: Not contributory.
Objective
Vital signs: BP 148/84, HR 82, temperature 99.2 °F, RR 16, SpO2 97% on room air. Weight 132 lb, down 5 lb from three months ago.
General: Alert, tired-appearing older woman in mild discomfort.
Head: Right temporal artery thickened, tender and nodular, with reduced pulse compared with the left. Scalp tender over the right temple.
Eyes: Visual acuity 20/30 both eyes with glasses. Pupils equal and reactive, no afferent pupillary defect. Fundi difficult to see without dilation; no obvious disc pallor on undilated exam.
Neck: Supple, no bruits.
Musculoskeletal: Pain with active shoulder abduction bilaterally; full passive range of motion.
Neurological: no cranial nerve deficits; full strength in all limbs; steady gait. Examination followed a focused, problem-centered approach (Bickley et al., 2021).
Cardiovascular: Regular rhythm; equal radial pulses; no subclavian bruits.
Assessment
Problem list: (1) new headache with jaw claudication, scalp tenderness and transient visual blurring in a woman over 50; (2) morning shoulder and hip stiffness; (3) weight loss and fatigue; (4) hypertension.
Differential diagnoses, ranked:
1. Giant cell arteritis. Age over 50, new temporal headache, jaw claudication, scalp tenderness, an abnormal temporal artery and polymyalgia symptoms. The 2022 classification criteria require age 50 or older and give points for these features, along with elevated inflammatory markers and biopsy or ultrasound findings (Ponte et al., 2022). Transient visual blurring raises concern for impending vision loss.
2. Polymyalgia rheumatica alone. Explains the stiffness, but not the cranial findings; it often coexists with giant cell arteritis.
3. Intracranial mass or subdural hematoma. New headache in an older adult warrants consideration, but the normal neurologic exam and the temporal artery findings favor arteritis.
4. Temporomandibular disorder. Can cause jaw pain with chewing, but not scalp tenderness, systemic symptoms or visual changes.
5. Herpes zoster before the rash. Can cause unilateral scalp pain, but not jaw claudication or stiffness.
Risk profile: high risk for permanent vision loss if untreated; risks of glucocorticoid treatment include hyperglycemia, worsening hypertension, bone loss on top of osteopenia and infection; lives alone, which affects follow-up and safety.
Plan
Diagnostic: Inflammatory markers (ESR and CRP), a blood count and a metabolic panel, all drawn today. Urgent temporal artery ultrasound or biopsy, ideally within two weeks of starting treatment.
Therapeutic: Because of the visual symptom, start high-dose oral glucocorticoids the same day without waiting for biopsy, consistent with the 2021 management guideline, which recommends prompt treatment and confirmation by biopsy or imaging (Maz et al., 2021). Begin calcium, vitamin D and plan bone protection; monitor glucose and blood pressure.
Referral: Same-day ophthalmology evaluation for the visual symptom; rheumatology referral.
Education: Explain the risk to vision and instruct her to call 911 for any new vision loss. Review steroid side effects.
Follow-up: Telephone check within 48 hours; visit in one week. Ask her daughter to help with transportation.
References
Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bates' guide to physical examination and history taking (13th ed.). Wolters Kluwer.
Maz, M., Chung, S. A., Abril, A., Langford, C. A., Gorelik, M., Guyatt, G., Archer, A. M., Conn, D. L., Full, K. A., Grayson, P. C., Ibarra, M. F., Imundo, L. F., Kim, S., Merkel, P. A., Rhee, R. L., Seo, P., Stone, J. H., Sule, S., Sundel, R. P., ... Mustafa, R. A. (2021). 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis. Arthritis Care & Research, 73(8), 1071-1087. https://doi.org/10.1002/acr.24632
Ponte, C., Grayson, P. C., Robson, J. C., Suppiah, R., Gribbons, K. B., Judge, A., Craven, A., Khalid, S., Hutchings, A., Watts, R. A., Merkel, P. A., Luqmani, R. A., Gatenby, P., Hill, C., Ranganathan, D., Kronbichler, A., Blockmans, D., Barra, L., Carette, S., ... Sreih, A. (2022). 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Annals of the Rheumatic Diseases, 81(12), 1647-1653. https://doi.org/10.1136/ard-2022-223480
Reading the DNP 605 Module 7 assignment instructions
The posted syllabus places the Older Adult Episodic SOAP Note in Week 15, during course wrap-up, after units on special populations including geriatrics. Students develop an episodic note for a geriatric patient with a new health concern, expanding the case study into a problem-centered assessment focused on the chief complaint: pertinent history, a focused physical examination, a problem list, differential diagnoses, a risk profile and a plan of care. This and the other written assignments are worth 10% combined. Expect a case in Canvas that you build on with realistic details. Read the case twice, note the red flags, and only then decide which details to add, so your expansion supports the reasoning rather than distracting from it.
Inside the DNP 605 Module 7 example
The note is episodic, so the history is focused on the chief concern with pertinent positives and negatives rather than a full review of systems. The objective section concentrates on the systems that matter for the differentials, including a careful temporal artery and eye examination. The assessment begins with a problem list, ranks five differentials with reasons, and adds a risk profile that addresses both the disease and its treatment in an older adult living alone. The plan acts urgently on the vision risk, consistent with guidelines, and addresses referral, education and follow-up. The plan names who follows up and when, which matters for an older adult living alone. Guidelines anchor each urgent step.
DNP 605 Module 7 rubric: what earns full marks
Episodic SOAP notes are usually graded on a focused, relevant history and exam, a clear problem list, ranked differentials with reasoning, a risk profile, and a plan that matches the assessment, with clear documentation. Faculty look for recognition of red flags, such as a new headache after age 50 with visual symptoms, and for plans that respond with appropriate urgency. Considering geriatric issues, such as treatment risks and living alone, shows a lifespan perspective. Guideline-based decisions strengthen the plan. Plans that address treatment risks specific to older adults, such as bone loss from glucocorticoids, show the lifespan focus of the course. Clear red-flag recognition earns credit.
DNP 605 Module 7 help from the desk
The most common weakness in episodic notes is too much irrelevant history and too little focused exam. Concentrate on the chief concern. Another is a differential list with no reasoning. Include a risk profile, which the syllabus requires. Respond to red flags with urgency. Consider medication risks in older adults. Expand the case realistically, without adding findings that change the diagnosis. If you would like help with an episodic SOAP note, bring it to the desk. Check that each differential is consistent with the details you add to the case, and avoid inventing findings that make the diagnosis too easy. Include a risk profile, as the syllabus requires. Keep the plan specific and dated.
Write yours, or have the desk draft it
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DNP 605 Module 7 questions, answered
Where can I find a free DNP 605 Module 7 sample paper?
The geriatric episodic SOAP note is shown above in full: a 79-year-old with a new temporal headache and jaw claudication, a focused exam, ranked differentials led by giant cell arteritis, a risk profile and urgent plan.
What is an episodic SOAP note?
A note focused on a specific new problem, with a targeted history and exam rather than a comprehensive one.
What are red flags for giant cell arteritis?
New headache after age 50, jaw claudication, scalp tenderness, temporal artery abnormalities, visual symptoms and polymyalgia symptoms.
Why start steroids before biopsy in suspected giant cell arteritis?
To prevent permanent vision loss; biopsy or imaging can still confirm the diagnosis shortly after treatment begins.
What is a risk profile in a geriatric SOAP note?
A summary of risks from the condition, its treatment and the patient's circumstances, such as living alone or bone health.