NU 664B Week 11 Discussion 1: Atopic Dermatitis
Regis University NU 664B Week 11 Discussion 1: Atopic Dermatitis-Step-By-Step Guide
This guide will demonstrate how to complete the Regis University NU 664B Week 11 Discussion 1: Atopic Dermatitis assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NU 664B Week 11 Discussion 1: Atopic Dermatitis
Whether one passes or fails an academic assignment such as the Regis University NU 664B Week 11 Discussion 1: Atopic Dermatitis depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NU 664B Week 11 Discussion 1: Atopic Dermatitis
The introduction for the Regis University NU 664B Week 11 Discussion 1: Atopic Dermatitis is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
Need a high-quality paper urgently?
We can deliver within hours.
How to Write the Body for NU 664B Week 11 Discussion 1: Atopic Dermatitis
After the introduction, move into the main part of the NU 664B Week 11 Discussion 1: Atopic Dermatitis assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NU 664B Week 11 Discussion 1: Atopic Dermatitis
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NU 664B Week 11 Discussion 1: Atopic Dermatitis
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
Stuck? Let Us Help You
Completing assignments can sometimes be overwhelming, especially with the multitude of academic and personal responsibilities you may have. If you find yourself stuck or unsure at any point in the process, don’t hesitate to reach out for professional assistance. Our assignment writing services are designed to help you achieve your academic goals with ease.
Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the NU 664B Week 11 Discussion 1: Atopic Dermatitis assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW.
Sample Answer for NU 664B Week 11 Discussion 1: Atopic Dermatitis
Differential Diagnosis:
Atopic dermatitis: Atopic dermatitis is the most likely diagnosis in this case. Atopic dermatitis is a chronic inflammatory skin condition which typically presents as a pruritic rash. Atopic dermatitis is most commonly seen in children which fits this patients demographics and the pruritus is a common feature of this condition. This patient has a family history that is significant for asthma, allergic rhinitis, and food allergies which is commonly seen in patients with atopic dermatitis and is the strongest risk factor for development of this condition which makes me highly suspicious that this rash is consistent with atopic dermatitis. This patient first developed these symptoms at the age of 4 which is consistent with a typical age of onset of atopic dermatitis at age 5 (Howe,2023). Excessively hot or cold environments can trigger an exacerbation of atopic dermatitis so the fact that this patient often has flare ups in the winter and also had exacerbation after returning from a vacation in a tropical climate further supports the diagnosis of atopic dermatitis (Dunphy et al.,2019). The diagnosis is further supported by the affected body parts of the popliteal and antecubital fossae which is the most common presentation of atopic dermatitis in children (Dunphy et al.,2019). The presence of Dennie-morgan lines also supports the diagnosis of atopic dermatitis and is often seen in this condition (Garzon et al.,2020). Atopic dermatitis is typically diagnosed based upon clinical presentation and history alone and ruling out other skin conditions (Dunphy et al.,2019)
Impetigo: In this patient he may have two skin conditions present as separate issues. On exam he does have Impetigo “crust-like” lesions with serum oozing found on the left elbow (Dunphy et al.,2019). Impetigo is the most common bacterial skin condition that occurs in the pediatric population and presents as a superficial vesiculopustular infection that is highly contagious (Dunphy et al.,2019). This diagnosis would need to be included on the differential due to the description of the area and how common it is in the pediatric population and even more common in atopic dermatitis due to breaks in the skin from scratching. Impetigo typically presents with pruritus and is often found on the extremities which fits with this clinical picture (Dunphy et al.,2019). Often impetigo is diagnosed based on clinical presentation and history however, it can be confirmed by culture (Dunphy et al.,2019). Due to the highly contagious nature of impetigo the diagnosis would further be supported if someone else exposed to the patient had the same presentation, this is not present in the case but doesn’t rule out the condition (Dunphy et al.,2019).
Psoriasis: Another condition to consider as part of the differential diagnosis in this patient would be psoriasis. Psoriasis is a skin condition that will also present with erythematous, scaly plaques commonly on the extensor elbows and knees (Dunphy et al.,2019). The diagnosis of psoriasis should also be considered in this case because like atopic dermatitis it is also triggered by either an excessively cold environment or triggered by prolonged exposure to sunlight which is consistent with this case (Dunphy et al.,2019). This diagnosis is less likely in this patient because he fits less with the clinical picture of psoriasis which typically has an age of onset either in the late teens to early 20s or late 50s to early 60s (Dunphy et al.,2019). This patient was asked about joint pain because patients with psoriasis may also experience psoriatic arthritis where joints are affected and painful (Dunphy et al.,2019). In this case the patient has no joint pain. Often a diagnosis of psoriasis can be made based on clinical presentation and history alone. In this case the presentation, history, and demographic features of the patient are more consistent with atopic dermatitis (Dunphy et al.,2019)
Contact dermatitis: This is a common skin condition that is either caused by an allergic immune mediated response or caused by irritation after repeated insults to contact with a caustic substance (Dunphy et al.,2019). This condition should be considered because of its prevalence and its typical presentation of a pruritic, erythematous rash. Four to seven percent of all dermatologic consultation are made due to contact dermatitis (Dunphy et al.,2019). This diagnosis is less likely in this case because the patient does not fit with the typical clinical picture for contact dermatitis which is more common in adult women (Dunphy et al.,2019). The diagnosis is also less likely as the patient’s parent denies any exposures to any new soaps, lotions or detergents and reports being very careful about what the patient is exposed to. The diagnosis of contact dermatitis is based on the clinical presentation and history which in this case is more consistent with atopic dermatitis (Dunphy et al.,2019)
Plan:
Primary Differential Diagnosis: Atopic dermatitis and case of impetigo on elbow
Pharmacology
The mainstay of treatment for atopic dermatitis in children is the lowest potency steroid possible for the shortest amount of time possible. Hydrocortisone 2% topically has already been tried which is a lower potency topical steroid. I would recommend applying a small amount of a higher potency topical steroid of triamcinolone 0.1% ointment twice a day for no more than two weeks. Will re-evaluate in the office in two weeks (Garzon et al.,2020).
Benadryl can help with pruritus and also help with sleeping at night due to its sedative properties. However, I would recommend discontinuing the Benadryl because sedating antihistamines are not generally recommended for children because they can cause daytime drowsiness which can negatively impact school performance and they can also have a paradoxical effect of causing hyperactivity in some children (Dunphy et al.,2019)
Would prescribe mupirocin 2% ointment topically twice a day for 5 days for the area of impetigo on the elbow ( Garzon et al.,2020).
Would recommend decreasing the Zyrtec to 5 mg daily which is the pediatric dosage.
Non-Pharmacology
A mild emollient such as Cetaphil should be used as substitute for soap.
Soak baths should be used instead of showering followed by liberal application of moisturizers after the skin is partially patted dry.
Any products containing strong scents, coloring agents, or perfumes should be avoided
(Dunphy et al.,2019)
Diagnostics: Would order an allergy panel ; would culture the oozing lesions for bacterial sensitivities.
Consults/Referrals: Referral to dermatology
Referral to allergist
(Dunphy et al.,2019)
Patient education:
- The impetigo is contagious until 24 hours of antibacterial treatment has been completed so need to avoid exposure to others (Garzon et al.,2020).
- Thorough cleansing of any skin breaks will help prevent impetigo (Garzon et al.,2020).
- Need to avoid any contact with persons with active herpetic lesions to prevent development of eczema herpeticum (Dunphy et al.,2019)
- Discuss how to monitor for secondary signs of bacterial infections that require evaluation (Dunphy et al.,2019)
- Discuss need to avoid triggers such as dust mites, pollen, and animal dander (Dunphy et al.,2019)
- Discuss ways to reduce sweating such as light bedclothes at night and avoiding occlusive garments (Dunphy et al.,2019)
- Fingernails need to be kept short and clean to avoid colonization with S. aureus to open skin areas from scratching (Dunphy et al.,2019).
- Need to upgrade moisturizers during the fall to petroleum jelly (Dunphy et al.,2019)
- I would discuss the use of bleach baths once or twice a week (Dunphy et al.,2019)
- I would discuss that the triamcinolone cream needs to be used for the shortest amount of time possible in order to reduce the risk of potential side effects such as thinning of the skin (Dunphy et al.,2019).
- I would discuss that triamcinolone cream should not be used on the face (Dunphy et al.,2019)
- Would discuss that topical steroids need to be used for shortest period of time possible because systemic absorption can lead to growth impairment, and cataract formation (Dunphy et al.,2019)
Follow up: I would recommend two week follow up appointment for evaluation if treatment has been effective.
Health Maintenance: An important item for health maintenance related to dermatology would be discussing sun protection including the use of sunscreen and protective clothing including wide brimmed hats when outside to protect the skin. This will help prevent flares of atopic dermatitis due to the fact that excessive sun exposure can cause flare ups (Dunphy et al.,2019).
Social Determinants of Health: Severe eczema is associated with denial of eczema prescriptions by insurance carriers or a lack of health insurance (Buckstein et al.,2022). The health care provider needs to think of the cost of medications and what insurance will cover when making treatment decisions. If an effective medication is prescribed but insurance will not cover or it is expensive then the patient is less likely to comply with treatment as they may not be able to afford to pick up the prescription. In this case, triamcinolone topical cream was prescribed because this is a medication that will likely be covered by insurance. There is a newer medication crisaborole that has been approved for the treatment of moderate atopic dermatitis that is effective in reducing itching that I would consider if the current treatment regimen is ineffective (Howe, 2023). However, due to the fact that the patient’s financial resources need to be taken into account this would not be in the primary treatment plan
References
Bukstein, D. A., Friedman, A., Gonzalez Reyes, E., Hart, M., Jones, B. L., & Winders, T. (2022).
Impact of social determinants on the burden of asthma and eczema: Results from a US patient survey. Advances in therapy, 39(3), 1341–1358. https://doi.org/10.1007/s12325-021-02021-0
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary Care (5th
ed.). F. A. Davis Company.
Garzon, M. D. L., Starr, N. B., Brady, M. A., Gaylord, N. M., Driessnack, M., & Duderstadt, K. (2020). Burns’ Pediatric Primary Care (7th ed.). Elsevier.
Howe, W. (2023) Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and
diagnosis . Uptodate.Retrieved March 18, 2023 from https://www-uptodate-com.regiscollege.idm.oclc.org/contents/atopic-dermatitis-eczema-pathogenesis-clinical-manifestations-and-diagnosis
Sample Answer 2 for NU 664B Week 11 Discussion 1: Atopic Dermatitis
HPI: A 9-year-old boy, Taumi, with a history of recurrent skin infections presents with extensive redness and pruritus of the popliteal and antecubital fossae, arms, and abdomen. He’s scratched the lesions, especially at night, with the result that his sleep was disturbed. Despite the use of chronic moisturizing therapy and topical corticosteroids, he is having a seasonal flare of his condition. When he was 6 years old, he also experienced bronchial asthma with a persistent cough. This is not the first time he’s experienced this type of rash and has had issues since he was 4 years old. His mothers, Patricia and Fran, are bringing him into the clinic today for another exacerbation. They have tried the following: diphenhydramine 25mg q8h prn, hydrocortisone 2% QID, Zyrtec 10mg QD, and Aquaphor QID. The medications help some, but he’s still uncomfortable.
Below is a list of questions of subjective information that I would ask the patient’s mother to help formulate the differential diagnoses and plan:
- Has your child been diagnosed with or currently being treated for asthma? Kampe et al., (2017) discussed the incidence of different skin conditions in both allergic and non-allergic asthmatic patients; explaining that self-reported allergic rhinitis and eczema were the most relevant skin conditions for this group of patients.
- Does your child have any history of environmental allergies that you know of?
- Does your son have any allergies to medications?
- Is your son experiencing any respiratory symptoms?
- Have you used any new skin products on your son, such as a new detergent, body lotion or body wash product?
- Has your child ever required a dermatology evaluation for this condition?
- Does your child exhibit signs of runny nose or watery eyes?
- Does your child complain of secretions in the back of his throat?
- Has your child experienced a fever with this type of condition?
- Has the rash spread to any other areas of the body other than what you have mentioned?
- Is there anything that makes the rash worse?
- Is your son taking any new medications other than what you mentioned?
- Are there any pets in the home?
- Has your son been bitten by an insect or tic?
- Has your son traveled anywhere within the last 30 days?
- Has your son had any exposure to sick contacts?
- Does your son have any food allergies? Research states that people who have food allergies have an increased risk of developing other conditions such as asthma and atopic diseases; the association between these two conditions can progress to a severe state causing anaphylaxis.
- Have you prepared any new foods or has your son eaten anything unusual?
References
Foong, R.X., du Toit, G., & Fox, A.T. (2017). Asthma, food allergy, and how they relate to each other. Frontiers Pediatrics, 5(89). doi:10.3389/fped.2017.00089
Kampe, M., Vosough, M., Malinovschi, A., Alimohammadi, M., Alving, K., Forsberg, B.,..& Janson, C. (2017). Upper airway and skin symptoms in allergic and non-allergic asthma: Results from the Swedish GA2 LEN study. Journal of Asthma, 55(3), 275-283. https://doi.org/10.1080/02770903.2017.1326132