08 Oct This is a discussion, no title page or running hea
This is a discussion, no title page or running header needed. Our focus is on Case study 3 which is classic herpes zoster (shingles). Need two other differential diagnosis maybe impetigo and eczema or contact dermatitis. Or if you have any other suggestions will be great. What makes shingles stand out is that it is localized and painful. Shingles can affect the trigeminal nerve and ocular nerves of the affected side. This is a famous SOAP note and will send you a template as well as an example. You are wonderful on SOAP notes. Discussion: Diagnosing Integumentary Disorders When entering examination rooms, advanced practice nurses often immediately begin assessing patients by looking for external abnormalities such as skin irritations or cloudy eyes. By making these simple observations, they can determine how to proceed with their patient evaluations. During the patient evaluation, advanced practice nurses will use initial observations to guide them in acquiring the necessary medical history, performing additional assessments, and ordering the appropriate diagnostics. The information obtained during this evaluation process will help in the development of a differential diagnosis. Once a diagnosis is made, the advanced practice nurse can consider potential treatment options and work with the patient to develop a plan of care. For this Discussion, consider the following three case studies of patients presenting with integumentary disorders. Case Study 1 A 46-year-old male presents to the office complaining of a pruritic skin rash that has been present for a few weeks. He initially noted the rash on his feet, but it then spread to between the fingers, his wrist, and waist. He notes that it does not seem to be on his face or trunk. He recently came home from a trip to Florida where he had stayed in multiple hotels. He takes occasional ibuprofen for knee pain, but denies taking other medications or having other health problems. He has no known drug allergies. The physical examination reveals a male with several tiny vesicles and scales in between the fingers, on the feet and ankles, around the patient’s wrist and around the belt line. Case Study 2 K.B., a 52 year old Irish American patient who present today complaining of “a mole” on the skin that is changing colors. He said he has had this ‘mole’ for almost two years. K.B. is a construction worker currently residing in Hawaii. As a teen he worked outside and visited the tanning bed several times a month. He is a worried that this “mole” doesn’t look like the others on his body. On your examination, you note, the lesion as round, dark colored in appearance, and scaly. You also note the mole has an irregular border and about 0.2cm in size. Case Study 3 J.V. 50 year old patient with history of eczema is here today complaining of lesions on the right side of her face and neck. She thinks it is a flare up of her eczema and is asking for a refill of her ointment, TAC 0.1%. She complains of some ‘itching’ and a bit of ‘tingling and pain’ to the lesions. She’s a pharmaceutical worker and thinks that the ‘pain’ maybe due to contaminate exposure. Denies any other associating symptoms. Below is a photo of the lesions. To prepare: • Review Part 5 of the Buttaro et al. text and the case studies provided • You will either select or be assigned one of the three case studies provided. • Reflect on the provided patient information including history and physical exams. • Think about a differential diagnosis. Consider the role the patient history and physical exam played in your diagnosis. • Reflect on potential treatment options based on your diagnosis. Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6531_Week_2_Discussion_Rubric • Grid View • List View Outstanding Performance Excellent Performance Competent Performance Proficient Performance Room for Improvement Main Posting: Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 44 (44%) – 44 (44%) Thoroughly responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. supported by at least 3 current, credible sources 40 (40%) – 43 (43%) Responds to the discussion question(s) is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 75% of post has exceptional depth and breadth supported by at least 3 credible references 35 (35%) – 39 (39%) Responds to most of the discussion question(s) is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of post has exceptional depth and breadth supported by at least 3 credible references 31 (31%) – 34 (34%) Responds to some of the discussion question(s) one to two criteria are not addressed or are superficially addressed is somewhat lacking reflection and critical analysis and synthesis somewhat represents knowledge gained from the course readings for the module. post is cited with fewer than 2 credible references 0 (0%) – 30 (30%) Does not respond to the discussion question(s) lacks depth or superficially addresses criteria lacks reflection and critical analysis and synthesis does not represent knowledge gained from the course readings for the module. contains only 1 or no credible references Main Posting: Writing 6 (6%) – 6 (6%) Written clearly and concisely Contains no grammatical or spelling errors Fully adheres to current APA manual writing rules and style 5.5 (5.5%) – 5.5 (5.5%) Written clearly and concisely May contain one or no grammatical or spelling error Adheres to current APA manual writing rules and style 5 (5%) – 5 (5%) Written concisely May contain one to two grammatical or spelling error Adheres to current APA manual writing rules and style 4.5 (4.5%) – 4.5 (4.5%) Written somewhat concisely May contain more than two spelling or grammatical errors Contains some APA formatting errors 0 (0%) – 4 (4%) Not written clearly or concisely Contains more than two spelling or grammatical errors Does not adhere to current APA manual writing rules and style Main Posting: Timely and full participation 10 (10%) – 10 (10%) Meets requirements for timely and full participation posts main discussion by due date 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) Does not meet requirement for full participation First Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings responds to questions posed by faculty the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives 8.5 (8.5%) – 8.5 (8.5%) Response exhibits critical thinking and application to practice settings 7.5 (7.5%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting 6.5 (6.5%) – 7 (7%) Response is on topic, may have some depth 0 (0%) – 6 (6%) Response may not be on topic, lacks depth First Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues Response to faculty questions are fully answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English 5.5 (5.5%) – 5.5 (5.5%) Communication is professional and respectful to colleagues Response to faculty questions are answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues Response to faculty questions are mostly answered if posed Provides opinions and ideas that are supported by few credible sources Response is written in Standard Edited English 4.5 (4.5%) – 4.5 (4.5%) Responses posted in the discussion may lack effective professional communication Response to faculty questions are somewhat answered if posed Few or no credible sources are cited 0 (0%) – 4 (4%) Responses posted in the discussion lack effective Response to faculty questions are missing No credible sources are cited First Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely and full participation posts by due date 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) Does not meet requirement for full participation Second Response: Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives 8.5 (8.5%) – 8.5 (8.5%) Response exhibits critical thinking and application to practice settings 7.5 (7.5%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting 6.5 (6.5%) – 7 (7%) Response is on topic, may have some depth 0 (0%) – 6 (6%) Response may not be on topic, lacks depth Second Response: Writing 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues Response to faculty questions are fully answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English 5.5 (5.5%) – 5.5 (5.5%) Communication is professional and respectful to colleagues Response to faculty questions are answered if posed Provides clear, concise opinions and ideas that are supported by two or more credible sources Response is effectively written in Standard Edited English 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues Response to faculty questions are mostly answered if posed Provides opinions and ideas that are supported by few credible sources Response is written in Standard Edited English 4.5 (4.5%) – 4.5 (4.5%) Responses posted in the discussion may lack effective professional communication Response to faculty questions are somewhat answered if posed Few or no credible sources are cited 0 (0%) – 4 (4%) Responses posted in the discussion lack effective Response to faculty questions are missing No credible sources are cited Second Response: Timely and full participation 5 (5%) – 5 (5%) Meets requirements for timely and full participation Posts by due date 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) NA 0 (0%) – 0 (0%) Does not meet requirement for full participation Total Points: 100 Name: NURS_6531_Week_2_Discussion_Rubric
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