Physical Assessmet

Mary is a 35 years old electrical engin" rel="nofollow">ineer who presents to the office for evaluation of a rash on her face that has been present for 1 week. She denies new soaps, detergents, lotions, environmental exposures, medications, and foods. The rash is across her face and the bridge of her nose. She states that she first noticed it after spendin" rel="nofollow">ing a week hikin" rel="nofollow">ing and campin" rel="nofollow">ing in" rel="nofollow">in the Appalachians. The lesions itch and are pain" rel="nofollow">inful. She has not tried anythin" rel="nofollow">ing to make it better, but she has noticed that goin" rel="nofollow">ing outdoors makes it worse. She denies any spread of the rash to other areas. She has never had this rash before. She has noticed some in" rel="nofollow">increased fatigue, fever, and weight loss. She denies headache, sore throat, ear pain" rel="nofollow">in, nasal or sin" rel="nofollow">inus congestion, chest pain" rel="nofollow">in, shortness of breath, cough, abdomin" rel="nofollow">inal pain" rel="nofollow">in, and pain" rel="nofollow">in with urin" rel="nofollow">ination, constipation, or diarrhea. She does have mouth soreness. She has noticed some in" rel="nofollow">increased muscle aches and pain" rel="nofollow">ins, which are worse in" rel="nofollow">in the hand and wrist. She denies early mornin" rel="nofollow">ing join" rel="nofollow">int stiffness or difficulty with bein" rel="nofollow">ing able to move in" rel="nofollow">in the mornin" rel="nofollow">ing. She denies temperature in" rel="nofollow">intolerance, polyuria, polydipsia, or polyphagia. She had a tonsillectomy at age 9 for chronic strep throat in" rel="nofollow">infections. She has been healthy as an adult. She has never had children. She has never been hospitalized for any reason. Her family history is significant for a mother with rheumatoid arthritis. Her father is healthy. She does not smoke; she drin" rel="nofollow">inks a glass of win" rel="nofollow">ine nearly every night with her din" rel="nofollow">inner; she denies illicit drug use. She completed a master’s degree in" rel="nofollow">in engin" rel="nofollow">ineerin" rel="nofollow">ing. She has lived with her boyfriend for the past 5 years. Patient is an alert young woman, sittin" rel="nofollow">ing comfortably on the examin" rel="nofollow">ination table. BP 112/66 mm Hg; HR 62 BPM and regular; respiratory rate 12 breaths/min" rel="nofollow">in; temperature 100.3°F. Several erythematous plaques scattered over the cheeks and the bridge of nose, sparin" rel="nofollow">ing the nasolabial folds. Normocephalic, atraumatic. Sclera white, conjunctivae clear; pupils constrict from 4 mm to 2 mm and equal, round, and reactive to light and accommodation. Oropharynx moist with erythema in" rel="nofollow">in the posterior pharyngeal wall; no exudates; shallow ulcers in" rel="nofollow">in the buccal mucosa bilaterally. Neck supple without cervical lymphadenopathy or thyromegaly. Full range of motion; no swellin" rel="nofollow">ing or deformity; muscles with normal bulk and tone. in" rel="nofollow">instructions: Make a whole history and physical examin" rel="nofollow">ination in" rel="nofollow">in a comprehensive manner. Based on this in" rel="nofollow">information, what is your presumptive nursin" rel="nofollow">ing diagnosis? SCABIES Teachin" rel="nofollow">ing and nursin" rel="nofollow">ing care plan on this case. 1- All written assignment and documentations must be in" rel="nofollow">in APA 6th edition format. 2- Double spaces, min" rel="nofollow">inimum 4 pages long , min" rel="nofollow">inimum 3 up to date bibliography. (UP to date means last 3 years.), Note: you can use your test book as bibliography too, bibliography have to be written in" rel="nofollow">in APA format. TEXTBOOK; Seidel's Guide to Physical Examin" rel="nofollow">ination 8th Author: Jane W. Ball;Joyce E. Dain" rel="nofollow">ins;John A. Flynn;Barry S. Solomon;Rosalyn W. Stewart Publisher: Elsevier - Health Sciences Division Edition: 8th Year: 2014 Format: Hardcover 736 pages ISBN 13: 9780323112406