NKDA.
None. No chronic GI disorders.
~24 hours.
Warm, dry overall but with reduced turgor on sternum. soap note gastroenteritis
Here’s a well-structured for a patient with gastroenteritis , with a strong emphasis on the Subjective and Objective features. SOAP Note: Acute Gastroenteritis Patient: 34-year-old male Chief Complaint: “Nausea, vomiting, and diarrhea for the past 24 hours.” Subjective (S) Onset: Symptoms began suddenly yesterday evening, approximately 6 hours after eating leftover takeout food. no wheezes or crackles.
Tachycardic, regular rhythm, no murmurs, rubs, or gallops. Capillary refill ~2–3 seconds. soap note gastroenteritis
Clear to auscultation bilaterally, no wheezes or crackles.