dermatology case stidy DB6 continuation

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Home>Homework Answsers>Nursing homework helprVersion: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=viewDERMATOLOGY CASE STUDYChief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.HPI:ÂE.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” 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.  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  AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills.ÂPMH:Diabetes Mellitus, type 2.Surgeries: NoneAllergies: AugmentinMedication: Metformin 500mg PO BID.Vaccination History: ÂImmunization 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. 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:ÂRight 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.ÂA:Primary Diagnosis:ÂProximal subungual onychomycosisDifferential Diagnosis: ÂIrritant Contact Dermatitis, Lichen Planus, Nail PsoriasisSpecial Lab:Fungal culture confirms fungal infection.ÂPlease see below:      Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy.QFor 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  Onychomycosis ?3-Provide patient education. Keep in mind the past medical history of this patienthypertension ,, diabetes mellitus 2 , salt intake , obesity6 years ago10.10.20191Report issueAnswer(1)Experttutor4.8(643)5.0(107)ChatPurchase the answer to view itNOT RATEDDermatologyCaseStudyPARTII.docx6 years agoplagiarism checkPurchase $8Bids(19)michael smithJane the tutoruniversity workDr R Judy MarkCatherine Owenskim woodsAngelina MayColossal GeniusEmily MichaelMiss ProfessorJessica LuisSamann060sarapaul2013hassan0906professor mitchimtrqhasibNurse sarainimohSaad FahimAZHARAKRAM300other Questions(10)What are type I and type II errors. What are their probabilities and what is meant by power of a test?Select a president from the table, “Presidents and Their ‘Doctrines,’” in Roskin, Chapter 4. Then write a 3-5 page paper on the doctrine that president used according to Roskin. Your research must include at least four (4) credible sources, apart from youqualityLegalHomework Help FOR RESEARCHER_D ONLY4 PAGESNRS-451V Week 3 Topic 3 DQ 1 – You have an idea to improve patient care…”Evaluating Supply Chain Performance” Please respond to the following:CJA 454 Week 2 Individual Assignment Community Problem-Solving PaperUnit 7: Unit 7: Power, Politics, Conflict and Negotiation – Discussion

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