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Itchy and inflamed skin condition in young children and teens.

Construct a response to at least 2 of your peers commenting on the adequacy and accuracy of the elements of
their SOAP note. For example, if you note the presence of objective data in the ‘S’ or subjective data in the ‘O’
discuss this with your peers.
For each colleague that you respond to list at least one subjective piece of data and/or one objective piece of
data that support the ‘A’ demonstrated in the note – or comment if there is no data/insufficient data to support
the ‘A’.
Responses need to address all components of the question, demonstrate critical thinking and analysis and
include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA
Parent should help children to prevent eczema from flaring up by avoiding triggers.
In addition, kids should take shorter baths or showers, and use mild unscented soaps and body products. 
Ask the pediatrician if it is okay to use oatmeal baths to help soothe itchiness.
Kids should wear comfortable clothes that do not irritate the skin, such as soft, breathable cotton fabrics; and
kids should avoid wearing wool clothing or using a wool blanket.
Parents should discourage scratching, because it can make the eczema worse, and dirty fingernails can cause
skin infections.
Kids should avoid extreme temperatures, and stay hydrated.
Use of moisturizes [ointment, mild lotions] can help control eczema, as well as reducing the amount of stress a
child may experience (Healthline, 2019).
Consultation/Collaboration: Pediatrician, dermatologist, dietician (Healthline, 2019).
Healthline. (2019). Eczema: Symptoms, Causes, and Treatment.
Kayla McClaren
Jul 8, 2021Jul 8 at 7:56am
Week 9 Discussion
Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life of
affected individuals as well as their families. AD is a highly pruritic (itchy) inflammatory skin disease and is also
one of the most common skin disorders in children (Kapur et al., 2018). Although the pathogenesis of the
disorder is not completely understood, it appears to result from the complex interplay between defects in skin
barrier function, environmental and infectious agents, and immune dysregulation. The disorder results in
significant morbidity and adversely affects quality of life. Not only are patients affected by the social stigma of a
visible skin condition, but the intense itching characteristic of the disease often leads to skin trauma and
significant sleep disturbances (Kapur et al., 2018).
Atopic Dermatitis
Worsening rash on bilateral arms without improvement after using hydrocortisone topical cream.
History of eczema
Reporting the area of her arms is very itchy and painful. Rating pain a 7/10, describes as a “burning feeling.”
Reports that nothing makes the pain better, but it helps when she itches.
States that right after she itches, it will start to burn worse and itch more.
Noted signs of excoriations on bilateral antecubital region, scaling on bilateral antecubital regions with
erythema about 3 inches in diameter.
Fever, unspecified
Temperature 100.7
Seborrheic dermatitis
Reports increased itching and flakiness on her scalp
There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that consider
the patient’s history and clinical manifestations (Kapur et al., 2018). Current management involves treatment
combinations to suppress inflammation, restore skin barrier function, and prevent superinfection. Systemic
immunosuppressants are reserved typically for treatment of moderate-to-severe AD but are associated with
adverse events (AEs) and not suitable for long-term use. Therefore, more effective, and well-tolerated
therapies are required that target the etiologic mechanisms of AD pathophysiology rather than simply providing
symptom relief (Wollenberg et al., 2019).
Allergy testing: Children with moderate to severe eczema have a high incidence of associated allergy. The
results of these tests in combination with the clinical history provide a more accurate assessment of the child’s
allergy status.
Lab: CBC-checking WBC count due to fever.
Children’s Motrin 300mg PO q 6-8 hours for fever and inflammation
Assists with pain control and treatment of fever.
OTC Children’s Diphenhydramine 25mg PO Q 4-6 hours PRN
Helps with itching.
Triamcinolone Acetonide 0.025% topical application to affected areas 2-4 times a day.
Assists with itching, swelling and irritation of AD.
Studies have shown that probiotics lower Bacteroidescounts in the fecal microflora of children with atopic
eczema than in healthy infants and suggested that probiotics can be used to treat AD in children (Huang et al.,
Tea Tree oil shampoo and conditioner
Aveeno soothing bath treatment colloidal oatmeal skin protectant
Relieves dry, itchy, irritated skin due to poison ivy, insect bites, eczema, sunburn, hives & rashes.
Wear cotton clothing
Avoid known allergens.
Bath daily (do not use extremely hot water).
Avoid extreme temperatures.
Medication application as suggested.
Apply moisturizers immediately after bathing.
Use mild, fragrance-free laundry detergents, and avoid fabric softeners.
Follow up in 1 week.
Consultation/Collaboration: 
Dermatologist: This physician specializes in conditions involving the skin, hair, and nails.
Allergist: specializes in the diagnosis and treatment of asthma and other allergic diseases.
Huang, R., Ning, H., Shen, M., Li, J., Zhang, J., & Chen, X. (2017). Probiotics for the Treatment of Atopic
Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in
Cellular and Infection Microbiology, 7.
Kapur, S., Watson, W., & Carr, S. (2018). Atopic dermatitis. Allergy, Asthma & Clinical Immunology, 14(S2).
Wollenberg, A., Howell, M. D., Guttman-Yassky, E., Silverberg, J. I., Kell, C., Ranade, K., Moate, R., & van der
Merwe, R. (2019). Treatment of atopic dermatitis with tralokinumab, an anti–IL-13 mAb. Journal of Allergy and
Clinical Immunology, 143(1), 135–141.

Sample Solution

The Last Great Explorer GuidesorSubmit my paper for examination By Brook Wilensky-Lanford The journey to discover the Garden of Eden seems like an occupation that ought to have fallen by the wayside a long time before the nineteenth century. Never again did the whimsical medieval topographies of Prester John or Columbus take into consideration the presence of a fascinating, pristine natural heaven. This was a more up to date, smarter age. We had vanquished the wild areas of the world. What's more, Darwin's Origin of Species, distributed in 1859, was gradually demonstrating that individuals and, state, the fowls of the air, were not made at the same time in a solitary spot on the globe. Darwin himself rejected the quest for a land purpose of sources in his 1871 Descent of Man. He permitted that: "It is to some degree progressively likely that our initial ancestors lived on the African mainland than somewhere else." But, he announced, there was additionally a huge gorilla that wandered Europe in the relatively recent past, and at any rate the earth is mature enough for primate species to have moved right around it at this point. In this way, "It is pointless to estimate regarding this matter." Victoria Woodhull, women's activist radical and free-love advocate, was less discretionary in her epic discourse "The Garden of Eden," which she conveyed oftentimes during the 1870s. Eden on Earth was rubbish: "Any school kid of twelve years old who should peruse the portrayal of this nursery and not find that it has no topographical centrality whatever, should be criticized for his ineptitude." Perhaps she was alluding to the minister voyager David Livingstone, who had proclaimed, while frantic with jungle fever in 1871, that heaven existed at the wellspring of the Nile, which he made a decision to be in the Lake Bangweulu area of Zambia. Livingstone was by all account not the only one despite everything searching for Eden. This valiant modern lifestyle was flipping around time-respected convictions. Advancement was proposing that people had rose after some time from our less-canny, carnal primate sources. In any case, Christianity had been demanding for quite a long time that people had slipped, through unique sin, from close heavenly statures in the Garden of Eden to the hopeless, debased society of the late nineteenth century. What was a cutting edge, loyal individual to accept? Enter William Fairfield Warren, recognized Methodist pastor and instructor. As the leader of Boston University, he realized science would characterize what's to come. However, he was reluctant to surrender his religious philosophy to the new order. How to weave the two points of view together? Irrationally, Warren looked to Eden. He set about making an interpretation of the Bible into science: Eden was "the one spot on Earth where the natural conditions are the most great." Genesis says Eden contains "each tree that is lovely to the eye or useful for nourishment"; Warren set "widely varied vegetation of practically unheard of force and extravagance." He observed a newfound actuality: a large number of years back, Earth had been a lot hotter. He followed the revealing of phenomenal animals without a moment's delay well-known and legendary, similar to the wooly mammoth, the dinosaur, and the goliath sequoia. He knew there was as yet one clear spot on the world guide, a spot where no one had been. Furthermore, he come to the unavoidable end result: the Garden of Eden is at the North Pole. It seemed well and good, as it were. Both Eden and the Pole had frustratingly opposed endeavors to find and guarantee them, regardless of hundreds of years of risky, costly undertakings. Warren distributed this hypothesis in 1881 as Paradise Found, The Cradle of the Human Race at the North Pole. The tome emphatically smelled with scholastic power. There were long sections in French, German, and antiquated Greek in the references. He drew on his claim to fame, near folklore, which he portrayed as "the study of the most seasoned conventional convictions and recollections of humanity." He knew the incredible epic old stories of the Hindus, the Celts, the Chinese, the Persians. In the nineteenth century, this was an uncommon, recondite assortment of information, brimming with allegorical echoes of Bible stories, and goal "proof" of Christian realities. The list of "creators alluded to or cited" in Paradise Found records 580 sources—for 495 pages of content. Directly by Darwin, there is Ignatius Donnelly, who guaranteed the lost mainland of Atlantis was genuine; it was demolished by the close impact of Earth with a comet. His 1882 book Atlantis was uncontrollably well known (Donnelly had another hypothesis—that Shakespeare's plays may really be composed by Francis Bacon—yet at that point, that was considered too crazy to be in any way paid attention to). A few commentators felt that Warren's wanton reference did his contention no favors, however obviously numerous perusers were not disturbed. The second printing of Paradise Found, discharged just months after the first, was peppered with tributes. Warren composed gladly of a "plain unschooled Bible understudy," Mr. Alexander Skelton, a mechanical engineer and metal forger of Paterson, New Jersey, who had freely landed at his own "strikingly complete and apt" contention for a North Pole Eden. Warren gloated that one Professor Heer, a haughty Swiss scientist, guaranteed that Warren was copying him. He likewise distributed a tribute from the British classicist, and reliable Anglican, Archibald Henry Sayce: "Temporarily, I may state that your view appears to me famously sensible… " (regardless of that Sayce was really alluding to a prior work of Warren's, about the cosmology of Homer's Iliad). Warren's hypothesis was "quickly overriding each previous speculation" on the two sides of the Atlantic—regardless of whether Warren said so himself. In this way, it involved jumbling dissatisfaction for him that other Eden hypotheses kept on showing up. A German paleologist, Moritz Engel of Leipzig, had the nerve to distribute The Solution to the Paradise Question all the while with Paradise Found. Engel's Eden was a desert spring in the desert outside of Damascus. His four waterways were flood downpours that vanish in the dry season, come May or June. Warren retaliated: Engel's Eden was terrible. Maybe Mr. Engel had never at any point understood Genesis, with its image of plenitude and bounty! It was additionally biased, as though he never at any point saw that there were "legends of the Happy Garden" found in many other antiquated customs! To top it all off, Engel's Eden was informal, putting forth no attempt to join "the realities and speculations of ethnologists and zoologists with regards to the beginnings of human life… . The ideal opportunity for investigations of such limitation as this is past." Warren's request that the North Pole Eden was the abrogating, definitive record was genuine. Yet, it might have been a little gullible, given the mystery that Warren himself uncovered on the absolute last page of his book: he didn't really figure his heaven could be found. He composes, sorrowfully: "Tragically deceased Eden is found, yet its doors are banned against us. Presently, as toward the start of our outcast, a sword turns each approach to keep the Way of the Tree of Life… " Arriving at Polar Eden, we could sit idle "however swiftly bow in the midst of a solidified destruction and, moronic with an anonymous wonderment, let fall a couple of hot tears over the covered and destroyed hearthstone of Humanity's soonest and loveliest home." The best way to return to Eden was in death, on the off chance that we acknowledge the penance of Christ. Follow Jesus throughout everyday life, and in death you can walk directly past the cherubim with their blazing swords. Furthermore, much the same as that, regardless of his earnest attempts to be the final word on Eden, Warren had accidentally opened the entryway for a totally different age of Eden-searchers. They started to spring up very quickly, and many even refered to Warren as legitimate proof for their own cases, similarly as Warren had finished with his 580 sources. It began with Warren's own partners in the Methodist church. Reverend E. D. Ledyard declared to a group of people of 5,000 at a retreat in upstate New York that Eden was fairly nearer to home. "In Chautauqua, we see one spot where Edenic benefits have been reestablished. Christ is the focal figure here. During that time Adam heaven is being recovered." In 1890, a three-section article in the San Jose, California evening paper entitled "Nursery of Eden: Its Position on the Globe Has Been Definitely Located" clarified that California's Santa Clara Valley had all the qualities of an Eden—flawless state, immaculate atmosphere, and the goliath sequoia. On the off chance that Warren was so enthused about the sequoia, the author notes, for what reason didn't he pick California? "In coming so close to reality, it appears to be abnormal that the capable logical essayist didn't get the genuine light with regards to the area of the first home of man." Warren couldn't have been glad to discover his work lauded by Wyoming author Willis George Emerson in the introduction to his 1908 sci-fi novel The Smoky God. The book professed to be the genuine record of a Norwegian angler who in 1829 had fallen through an opening at the North Pole into the inside of the Hollow Earth—where the Garden of Eden is reachable by monorail. "In his painstakingly arranged volume, Mr. Warren nearly stubbed his toe against the genuine truth, yet missed it apparently by just a tiny bit." Dr. George C. Allen, a Boston University philologist, trusted him associate Warren that Eden was at the North Pole—yet he made one significant change. In 1921, he guaranteed that the North Pole moves altogether around the globe at regular intervals, so "cautious scientific calculations bring the first heaven where Ohio presently is." Warren himself, who passed on in 1929 at 96 years old, remained totally, outreachingly persuaded of his unique hypothesis' veracity. The North Pole Eden "has shown itself the preeminent and unavoidable speculation from the real factors of current information regarding man and the world. It has fit the most seasoned customs of religion and the most recent accomplishments of science…

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