Please follow directions very carefully. Should you have any questions please don’t hesitate to ask. Read the case study and answer the questions as directed. <\/p>\n
_________________________________________________________________________________________<\/p>\n
Following Case Study Question: As an NP student, needs to determine the medications for Tinea Pedis.<\/p>\n
According to the ACC\/AHA Guidelines, what antifungal medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.<\/p>\n
WEEK 5: DISCUSSION QUESTION IN DISCUSSION BOARD<\/p>\n
DERMATOLOGY CASE STUDY <\/p>\n
ACC\/AHA Guidelines<\/p>\n
Chief complaint: \u201c I have scaly crust in sole of feet and moist white crusts between my toes since I started using boots warm weather\u201d for past 2 weeks. <\/p>\n
HPI: E.D a 45-year-old hispanic female presents to the clinic for complaint of itching in feet and scaly curst in sole of feet and moist white crusts between toes. She developed a red, itchy rash consistent with hypersensitivity reaction. She also indicates that she has noticed that her symptoms are worsening for past 2 weeks and it started after she started to use boots in warm weather. She has symptoms of red, itching rash consistent with a hypersensitivity reaction and tinea pedis. She wore about 2 weeks ago her mother\u2019s shoes without socks and her mother has history of Tinea Pedis.<\/p>\n
She has tried lotrimin AF cream for itching and it did not help relief her symptoms. She has not tried other remedies. <\/p>\n
Denies associated symptoms of fever, chills, pain or any other symptoms. <\/p>\n
PMH:<\/p>\n
Diabetes Mellitus, type 2. Peripheral Vascular disease. Varicose Veins. <\/p>\n
Surgeries: None<\/p>\n
Allergies: Penicillin<\/p>\n
Vaccination History:<\/p>\n
She receives an annual flu shot. Last flu shot was this year<\/p>\n
Social history:<\/p>\n
High school graduate, married and no children. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.<\/p>\n
Family history:<\/p>\n
Both parents are alive. Father has history of DM type 2, Tinea Pedis. <\/p>\n
mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis. <\/p>\n
ROS:<\/p>\n
Constitutional: Negative for fever. Negative for chills. <\/p>\n
Respiratory: No Shortness of breath. No Orthopnea<\/p>\n
Cardiovascular: + 1 pitting leg edema. + Varicose veins. <\/p>\n
Skin: + rash crusted white in feet and inter-digit in feet. <\/p>\n
Psychiatric: No anxiety. No depression. <\/p>\n
Physical examination:<\/p>\n
Vital Signs<\/p>\n
Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130\/70 T 98.0 po P 88 R 22, non-labored<\/p>\n
HEENT: Normocephalic\/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness. <\/p>\n
NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.<\/p>\n
LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress. <\/p>\n
HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally. <\/p>\n
ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.<\/p>\n
GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. <\/p>\n
MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.<\/p>\n
SKIN: +Dryness, No open lesions. +Dry crusts in sole of feet. + moist crust in between toes. <\/p>\n
PSYCH: Normal affect. Cooperative. <\/p>\n
Labs:: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98<\/p>\n
A:<\/p>\n
Primary Diagnosis: Tinea Pedis<\/p>\n
Secondary Diagnoses:<\/p>\n
Atopic Dermatitis<\/p>\n
Xerosis<\/p>\n
Pruritus<\/p>\n
Differential Diagnosis:<\/p>\n
Peripheral Vascular Disease (PVD) (173.9)<\/p>\n
P:<\/p>\n
Medications:<\/p>\n
Tylenol 650 mg PO Q4 hours as needed for arthritis pain<\/p>\n
Labs: CBC with diff to evaluate for infection and baseline lab. CMP, PT\/INR to evaluate status of liver and kidneys. <\/p>\n
Referrals: may refer based on effect of medication therapy given for 2 weeks.<\/p>\n
Follow up: return to office in 2 weeks to evaluate her symptoms.<\/p>\n
Additional lab results:<\/p>\n
Fungal culture confirm that she has fungal infection. <\/p>\n
Question: As an NP student, needs to determine the medications for Tinea Pedis.<\/p>\n
According to the ACC\/AHA Guidelines, what antifungal medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.<\/p>\n \n
Please follow directions very carefully. Should you have any questions please don’t hesitate to ask. Read the case study and answer the questions as directed. _________________________________________________________________________________________ [\u2026]<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[],"tags":[],"yoast_head":"\n