Justine Lawrence ihuman
Justine Lawrence ihuman
History and physical Exam
How can I help you today?
Is your rash painful or itchy?
Does anything make your rash better or worse?
When did your rash start?
Are you using any new lotions, soaps or deodorants?
has anyone else you know developed these symptoms?
have you been having fevers?
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I-HUMAN CASE STUDY: EVALUATING AND MANAGING INTEGUMENTARY CONDITIONS
This course will require you to complete a series of case studies using the i-Human software application. The i-Human Patients (IHP) Case Player enables you to interact with virtual patients for the purpose of learning patient-assessment and diagnostic-reasoning skills. With IHP, you will be able to independently interview, examine, diagnose, and treat virtual patients and receive expert feedback on your performance.
The integumentary system is susceptible to a variety of diseases, conditions, and injuries, ranging from the bothersome but relatively innocuous bacterial or fungal infections that are categorized as disorders to skin cancer and severe burns, which can be life-threatening.
For this Case Study Assignment, you will examine your first case study and work with a patient with an integumentary condition. You will formulate a differential diagnosis, evaluate treatment options, and then create an appropriate treatment plan for the patient.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
TO PREPARE:
Review this week’s Learning Resources. Consider how to assess, diagnose, and treat patients with integumentary conditions.
Access i-Human from this week’s Learning Resources and review this week’s Justine Lawrence ihuman case study. Based on the provided patient information, think about the health history you would need to collect from the patient.
Consider what physical exams and diagnostic tests would be most appropriate to gather more information about the patient’s condition.
Reflect on how the results would be used to make a diagnosis.
Identify three to five possible conditions that may be considered in a differential diagnosis for the patient.
Consider the patient’s diagnosis. Think about clinical guidelines that might support this diagnosis.
Develop a treatment plan for the patient that includes health promotion and patient education strategies for patients with integumentary conditions.
Assignment
As you interact with this week’s i-Human patient, complete the assigned Justine Lawrence human case study. For guidance on using i-Human, refer to the i-Human Graduate Programs Help link within the i-Human platform.
BY DAY 7
Complete your Assignment in i-Human
Upload your PDF from i-Human to this assignment
Justine Lawrence ihuman Case: Key Findings
Key Findings
Bilateral inner thighs with 10 × 12 cm raised, confluent, erythematous papi blisters in various stages
Left ventral forearm with 6 cm linear, erythematous papules, and yellow-red
Itching progressing to tenderness
New exposures: Wild brush plants
New exposures: Hot tub
New exposures: Oily suntan lotion
New exposure: Scallops
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Case: Key Findings Feedback
Bilateral inner thighs with 10 × 12 cm raised, confluent, erythematous papules and blisters in various stages: The location of the original rash provides information on the manner of spread. This information, in concert with the morphology of the rash, is pivotal for determining the cause of the rash. Therefore, it is the most significant active problem (MSAP).
Left ventral forearm with 6 cm linear, erythematous papules and yellow-red blisters: This secondary location indicates the pattern of the rash’s spread. Along with its similar appearance to the original rash, this secondary rash is related to the MSAP
Itching progressing to tenderness: The itchy nature of the rash along with its progression to tenderness is pivotal for deciding the order of the differential diagnosis list. This finding is related to the MAP.
New exposures: Wild brush plants: Exposure to wild plant material is a key historical element that could indicate an origin for the MAP. Since a direct correlation is uncertain, it is unknown if this finding is related to the MSAP
New exposures: Hot tub: Hot tub water can contain bacteria (such as Pseudomonas) and chemicals that cause skin irritation or infection, so exposure to it is a key historical element that could indicate an origin for the MSAP Since a direct correlation is uncertain, it is unknown if this finding is related to the MSAP.
New exposures: Oily suntan lotion: Exposure to the chemicals, preservatives, and scents of a new lotion could indicate an origin for the MAP This new topical lotion can lead to skin irritation or can intensify sunlight rays in some cases. Since a direct correlation is uncertain, it is unknown if this finding is related to the MSAP
New exposures: Scallops: Exposure to new food could indicate an origin for the MSAP. Since a direct correlation is uncertain, it is unknown if this finding is related to the MSAP
Case: Problem Statement
The patient, a 25 yo otherwise healthy female, presents with 2 days of intensely pruritic erythematous papular rash on the inner thighs and left inner forearm. Recent exposures include hiking through the woods, hot tub use, new lotion use, and ingesting scallops for the first time in her life. Physical examination shows a 6 cm set of linear, circumscribed, erythematous blisters on the left inner forearm and a 10 x 12 cm scattered contiguous erythematous papular rash with surrounding superficial excoriations on the inner thighs. Vitals Ad the remaining physical examination are unremarkable.
Case: Management Plan
Pharmacologic Care:
• Apply clobetasol propionate 0.05% cream twice a day until clear.
• Take OTC cetirizine 10 mg 1 tab PO daily as needed for itching.
Supportive Care:
• Take oatmeal baths.
• Apply cool, wet compresses to affected areas.
• Apply topical calamine lotion or aluminum acetate to affected areas
Patient Education:
Educated patient on the diagnosis of contact dermatitis, potential etiologies, treatment regimen, and prognosis.
• Advised the patient to avoid poison ivy, oak, and sumac. Explained plant appearance.
• Educated patient on medications, including indications, proper administration, side effects, and red flag symptoms for discontinuation.
• Advised patient to wash all clothing, towels, sheets, etc., in hot water to remove potentially irritant oils.
Follow-Up:
• Follow up in the clinic if symptoms do not start to improve within 48-72 hours.
• Discussed warning signs to call the clinic immediately or to go to the ER, including but not limited to difficulty breathing, increased swelling, vomiting, fever, purulent skin discharge, or other concerning symptoms. Justine Lawrence ihuman
