Nursing Case Study On Rash

This week of maternity clinical rotation, I had a patient Mrs. M was 35-year-old G2P2. She gave birth to a boy by cesarean section at 41 weeks. Mrs. M had Rh+ and Blood group was O+. She was rubella immune, +PPD and had no known allergies. Her GBS, HBsAg, and RPR status were negative.

The NMC Code (2015) states that nurse must ensure the get informed consent before carrying out any action. On examination, Ella had very dry and flaky skin with area of red patches and therefore it was diagnosed by the appearance and the elimination of other factors that Ella had mild eczema on her face and arms. This was also confirmed by the practice teacher. Eczema is an inflammatory skin condition that causes intense itching of the affected area and sometimes can be scaly red and itchy (National Eczema society, 2016). Assessment of eczema in babies and children must be holistic, taking into account physical and psychosocial factors. There is no cure for eczema and treatments aim to control the disease. First-line treatment consists of emollients, but many babies and children will also require the use of topical corticosteroids and other treatments as appropriate (NICE,2007). Moreover, on observation the reddened area there appeared to be no signs of broken skin, infection therefore requiring antibiotics or topical steroid treatment (NICE, 2007). There was currently no need for a General Practitioner (GP) referral and as advised in the NPC (1999) only in genuine need should prescriptions be

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

The patient was referred for a new itchy and tender bilateral groin lesions that the patient says will drain pus. He also has multiple other complaints. He gives a history of being allergic to DOXYCYCLINE. As previously stated, he has tender sites which can drain pus off and on in his groin for years. There is also history of facial acne and scalp acne since his late teens. He took Accutane during his 20s with improvement by history. He flared and repeated Accutane about one year after completing the first course by his history. He is bathing with unscented Dove and uses cocoa butter lotion. He also has a second problem of itching over his back, shoulders, and arms, and legs

Breasts: no masses, no nipple retraction, no discharge. Heart: S1 and S2, no gallops, rubs, or murmurs appreciated. Abdomen is scaphoid, soft and non-tender with positive bubble sounds. Pelvic/ Rectal: deferred as patient has recently visited her GYN for a routine Pap smear. Neurologic exam reveals normal motor strength in all muscle

No birthmarks. No rashes, lesions or skin discoloration. Showers daily and dyes hair every 6 months. Tries to keep nails clean and manicured and likes to paint nails red. Nails are not pitted or clubbed.

Patient states that she keeps her hair short, and that she washes it and conditions it daily.

8. Dr. Williams treated a 9-month-old new female patient in the office for diaper rash. An expanded problem focused history and exam were performed, and MDM was straightforward.

No scalp lesions. Dry eyes with conjunctival injection. Mild exophthalmos. Dry nasal mucosa. Marked cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palette. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema, she has some patches but no obvious skin breakdown. She had some fissuring in the buttocks crease. PULMONARY: Clear to precussion and auscultation, bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sounds. NORALOGIC EXAME: Cranial nerves ii – xii are grossly intact, diffuse hyporeflexia. MUSCULAR SKELETAL: Erosive destructive changes in elbows, wrist, and hands consistent with rheumatoid arthritis. Has had bilateral total knee replacements with stovepipe legs and perimalledal pitting edema 1+. I feel no pulse distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and there significance. We discussed her situation and I offered her psychiatric services, she refused for now.

The working diagnosis is that this patient is suffering from Angioedema as a result of Anaphylaxis and developing Urticaria. Angioedema is the swelling of deep layers of the skin due the accumulation of fluid, symptoms of Angioedema include swelling of the eyes, lips, hands and feet.

Her hematocrit levels could be low, along with her red blood cells being pale and immature because she isn’t getting the proper nutrition, and her over

Jennette is a seven months old female. Three to four weeks ago (unknown) a cat bite Jennette in her face (on the lower part of her cheekbone). Jennette was at a birthday party. It is unknown how the cat bites Jennette in the face. Jennette's mom Kristi did take Jennette to the doctor in Brookhaven or Summit. Kristi took Jennette at 7:45 pm and Kristi did not notify the father (unknown) until 8:00 pm. Jennette also has a bad diaper rash. The diaper rash has Jennette bottom (butt) raw. The diapers rash begin on her butt cheek all the up to her vagina. While bathing Jennette, she will not sit in the tub on her bottom; due to her but being raw. Jennette just cried. Jennette's butt is always red. It appears that Kristi does not change

Skin- she has some mild equimosis on her skin and some anathema. She has patches but no obvious skin breakdown. She has no fissuring in the buttocks crease.

The first and most common form is the Plaque Psoriasis. It is an infected area that appears red on the base of the skin and covered by silvery scales. About 80% of patients with the disorder have this type of form. The second form is the Guttate Psoriasis where there are small infected areas are on the trunk, limbs, and scalp. This type of form can be triggered by infections in the upper respiratory such as a sore throat. The third form is called the Pustular Psoriasis where the infected areas will develop noninfectious pus inside blisters on the skin. This is said to be triggered through medication, infections, stress, or exposure to certain chemicals. The fourth form is called the Inverse Psoriasis. This form is caused by irritation such as friction or sweating and will cause the infected area to appear smooth and red in the folds of the skin near the genitals. Lastly, the Erythrodermic Psoriasis form is the most severe among the forms. It appears throughout the body causing reddening and scaling of the skin and can be triggered by severe sunburn or specific medication.