Version:1.0 StartHTML:000000319 EndHTML:000022967 StartFragment:000001561 EndFragment:000022798 StartSelection:000001561 EndSelection:000022788 SourceURL:https://fnu.blackboard.com/webapps/discussionboard/do/conference?toggle_mode=read&action=list_forums&course_id=_14292_1&nav=discussion_board_entry&mode=view
DERMATOLOGY CASE STUDYChief complaint:Â Â â€œ My right great toe has been hurting for about 2 months and now itâ€s itchy, swollen and yellow. I canâ€t wear closed shoes and I was fine until I started going to the gymâ€.HPI:Â E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and â€œyellowâ€ right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief. Â She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin Â AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills.Â PMH:Diabetes Mellitus, type 2.Surgeries: NoneAllergies:Â AugmentinMedication: Metformin 500mg PO BID.Vaccination History: Â Immunization is up to date and she received her flu shot this year.Social history:College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.Family history:Both parents are alive. Father has history of DM type 2, Tinea Pedis.Â mother alive and has history of atopic dermatitis, HTN.ROS:Constitutional: Negative for fever. Negative for chills.Respiratory: No Shortness of breath. No OrthopneaCardiovascular: Regular rhythm.Skin: Right great toe swollen, itchy, painful and discolored.Psychiatric: No anxiety. No depression.Physical examination:Vital SignsHeight: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-laboredHEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.SKIN:Â Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.PSYCH: Normal affect. Cooperative.Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.Â A:Primary Diagnosis:Â Proximal subungual onychomycosisDifferential Diagnosis:Â Â Irritant Contact Dermatitis, Lichen Planus, Nail PsoriasisSpecial Lab: Fungal culture confirms fungal infection.Â Please see below:Â Â Â Â Â Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy.
For Week 6, please address the following:
1- Specify when to refer the patient after therapy and why? Provide rationale.
2- According to the recommended guidelines, what are the non-pharmacological approaches to Â Onychomycosis ?
3-Provide patient education. Keep in mind the past medical history of this patient
hypertension ,, diabetes mellitus 2 , salt intake ,
Do you need a similar assignment done for you from scratch? We have qualified writers to help you. We assure you an A+ quality paper that is free from plagiarism. Order now for an Amazing Discount! Use Discount Code “Newclient” for a 15% Discount!NB: We do not resell papers. Upon ordering, we do an original paper exclusively for you.
The post Dermatology Case Stidy DB6 Continuation appeared first on My Nursing Experts.
Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.
You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.Read more
Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.Read more
Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.Read more
Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.Read more
By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.Read more