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  • [Solved] Nursing Mod 6. Pamphlet Assignment

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    _**Planning for "Pamphlet Presentation & Peer Review" Assignment**_ – In preparation for your module 7 assignment, choose a cultural group that you believe is essential for your fellow colleagues to understand in the context of your healthcare setting. – Consider the diversity of patients you may en…

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    Assignment Prompt & Instructions

    _**Planning for "Pamphlet Presentation & Peer Review" Assignment**_

    – In preparation for your module 7 assignment, choose a cultural group that you believe is essential for your fellow colleagues to understand in the context of your healthcare setting.
    – Consider the diversity of patients you may encounter.
    – Begin conducting thorough research on the chosen cultural group.
    – Compile key information that will be useful for your colleagues to understand and apply in their practice.

    – Include information on:
    – healthcare beliefs,
    – health practices,
    – communication styles,
    – family dynamics; and
    – any specific health disparities.
    – Include practical tips, strategies, or scenarios that illustrate culturally competent care within the pamphlet.
    – Provide examples of how your colleagues can integrate this knowledge into their practice.
    – Incorporate images, infographics, and culturally relevant visuals to enhance the content.

    Submit your plan as an outline with details on how you plan to design your presentation of the pamphlet

    *******Plan the layout, design, and format of your pamphlet. ******Consider visual elements, headings, and the overall structure to make the content engaging and easy to follow.******

    – a year ago

  • [Solved] Nursing Mod.6 Assignment Policy

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    _**Policy Analysis**_ This assignment is an analysis of local, state FLORIDA, or federal health policy. 1. **Select a state** health policy reform innovation 2. **Discuss** the rationale for the policy, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, …

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    Assignment Prompt & Instructions

    _**Policy Analysis**_

    This assignment is an analysis of local, state FLORIDA, or federal health policy.

    1. **Select a state** health policy reform innovation
    2. **Discuss** the rationale for the policy, how it was adopted (e.g., federal waivers, passage by state legislature), the funding structure, and (to the extent statistical data are available) its impact. ethical outcome based on evidence.
    3. **Examples** of state innovations include Maryland’s hospital rate setting, Vermont’s single payer system, and Massachusetts’ health reforms

    **Submission Instructions:**

    – Assignment is to be clear and concise with proper grammar, punctuation and misspelling.
    – Formatted to be current APA style and 5-7 pages in length, excluding the title and references page. Incorporate a minimum of 5 current (published within the last five years) _scholarly journal articles_ or _primary legal sources_(statutes, court opinions) within your work.

    – a year ago

  • [Solved] Mod.6IN DiscussionReply

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    You should respond to both discussions separately–with constructive literature material- extending, refuting/correcting, or adding additional nuance to their posts. Minimum 150 words each reply with references under each reply. Incorporate a minimum of 2 current (published within the last five year…

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    Assignment Prompt & Instructions

    You should respond to both discussions separately–with constructive literature material- extending, refuting/correcting, or adding additional nuance to their posts.

    Minimum 150 words each reply with references under each reply.

    Incorporate a minimum of 2 current (published within the last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles should be referenced according to the current APA style (the online library has an abbreviated version of the APA Manual).

    Discussion 1

    **The Role of Nurses in Addressing Workforce Culture Issues through Health Policy**

    Healthcare remains a dynamic industry fraught with complexity, as it integrates technology and human wellbeing while balancing efficiency and compassion. Nurses are arguably the most impacted and critical group within this structure. Today, nurses bear the burden of a persistent challenge in the workforce culture, which is burnout. Moreover, they have little power to change it, due to insufficient levels of organizational structure. This reality stifles adaptability and policy level flexibility across most healthcare systems.

    From Mason et al. (2016), we understand how inadequate policy engagement amongst nurses results in a lack of workforce policies that directly target the nurse’s mental and physical health and does reclaim them as a priority. To plug this policy gap, he proposes organizational wellness initiatives that avoid confronting the fundamental issues—the nurse-patient ratio and mental health leave policies. This is in line with the prevailing approach towards safeguarding concepts which further endangers nurses’ mental wellbeing. The impacts of such guarded approaches are evident in Californian hospitals, where staff-patient ratio mandates have paradoxically improved job satisfaction, reduced burnout, and heightened patient satisfaction metrics. Despite the overwhelming need for inclusive advocacy which enables practical implementation of legislation such as these that enable markedly better work conditions for nurses, such protective policies need to be more widely adopted.

    Nurse voice exclusion from organizational leadership and policy development is another cultural problem in healthcare. Nurses, who make up the largest portion of the healthcare workforce, are frequently left out of administrative and policy making positions at hospitals and are not included in policy think tanks. According to Mason et al. (2016), political competence is imperative for nurses. Nurses can navigate and influence the processes that govern their workplaces by forming coalitions and partnerships. The text recommends participating actively as a nurse into professional organizations as one of the main strategies to shift the balance of power in their favor.

    Misinformation and lack of inclusion also persist as barriers. A nurse population that reflects the local population is needed to provide culturally competent care and to foster an inclusive work environment. However, the organizational hierarchies continue to be dominated by white leaders, with little to no change for nurses of color. Mason et al. (2016) argue that the lack of leadership opportunities for minority nurses can be addressed through policy changes that increase their educational sponsorship, mentorship, and leadership training. Nurse leaders need to actively support change at the national and institutional level by adopting policies that promote equity and eliminate systemic discrimination to advancement.

    Effective collaboration across generational and professional lines shapes the workplace culture. In healthcare, as Mason et al. (2016) point out, there is a growing reliance on team-based care which demands integrating communication style and value cross boundaries of age and profession. Nurses can promote a culture of respect and shared governance by supporting interprofessional education and collaborative leadership policies in clinical and academic settings.

    To summarize, the issues of culture in the healthcare workforce are intricate and enduring, but nurses have the optimal opportunity to address them beyond the bedside, by taking part in policy and politics. Nurses need to amplify their voice as advocates and, together with Mason et al. (2016), call for policy action to redefine nurses’ workspaces, making them healthier and more equitable, all to enhance patient care delivery.

    Discussion 2

    The connection between politics and advanced practice nursing is complex and deeply rooted in long-standing power structures. Advanced practice nurses are highly educated and capable providers, yet their ability to practice independently is often restricted by laws that do not reflect their training or the needs of patients. These restrictions are not just clinical, they are political.

    Advanced practice nurses face significant difficulties when trying to influence the laws that govern their profession. In many cases, legislative decisions about their practice are made by individuals who are not familiar with what these healthcare providers do. Medical associations often have more political influence and resources. They use this power to maintain control over healthcare regulations, including those that limit advanced practice nurses’ scope of practice. This imbalance creates an uneven playing field. These providers must work harder to be heard by lawmakers. Unlike larger, well-funded medical groups, advanced practice nurses often lack strong lobbying organizations and political action committees. Without these tools, it is difficult to counter the influence of competing interests that benefit from maintaining the status quo (Schorn et al., 2022).

    Power dynamics between healthcare stakeholders make progress slow. Physicians, hospitals, insurers, and even some legislators have competing priorities. For example, some physicians view independent APRN practice as a threat to their professional territory or income. This leads to resistance, even when the evidence clearly supports the safety and effectiveness of APRN-led care. Federal regulations also play a major role in shaping APRN practice. Medicare and Medicaid reimbursement policies are key examples. These programs are controlled at the federal level and often reimburse APRNs at lower rates than physicians, even for identical services. This affects not only income but also the willingness of employers and systems to fully integrate APRNs into care models (Kleinpell et al., 2022).

    The Centers for Medicare & Medicaid Services is one of the most influential federal organizations in this area. It controls payment structures and plays a large role in how APRNs are utilized in hospitals, clinics, and long-term care settings. The Department of Health and Human Services also influences practice through funding priorities and program regulations. These agencies impact everything from how APRNs are trained to where they are most needed. In addition to agency-level influence, major federal legislation also shapes the APRN landscape. The Affordable Care Act, for example, created new pathways for APRNs to serve in primary care roles through funding for community health centers and expanded access initiatives. It also emphasized preventive care and team-based models, which align with the strengths of APRN practice. However, the success of these provisions depends heavily on state-level implementation and political support, which varies widely. As such, national legislation can be a powerful tool for expanding APRN impact, but only when it is backed by state-level policies that remove scope-of-practice barriers (Phillips, 2024).

    Federal funding sources, such as grants from the Health Resources and Services Administration, can help expand APRN roles in underserved areas. However, the availability and distribution of these funds are often tied to political agendas. Changes in administration can shift priorities, creating uncertainty about long-term support for APRN initiatives. All of these challenges show how tightly APRN practice is tied to politics. It is not enough to rely on clinical evidence alone. Advocacy and political engagement are essential. APRNs must become active in shaping health policy. That means joining professional organizations, contacting legislators, and supporting policy reform that promotes full practice authority (Kleinpell et al., 2022).

    More APRNs are now running for public office, serving on healthcare boards, and participating in grassroots campaigns. These efforts matter as they not only push for policy change but also increase public awareness of APRN contributions. When APRNs take leadership roles in political spaces, they help shift the conversation toward a more equitable and effective healthcare system. The future of the profession depends on this kind of bold and sustained advocacy.

    – a year ago

  • [Solved] instr

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    – a year ago **files (2)** – ## IHUMANTEMPLATE1.docx – ihuman9instructions.docx **## IHUMANTEMPLATE1.docx** **NAME** **UNIVERSITY NAME** **CLASS** **PROF NAME** **DATE** **NRNP 6531 i-Human Template / Week 2 Case** Management Plan Template 1. Problem Statement a. How would you present this patient …

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    Assignment Prompt & Instructions

    – a year ago

    **files (2)**

    – ## IHUMANTEMPLATE1.docx

    – ihuman9instructions.docx

    **## IHUMANTEMPLATE1.docx**

    **NAME**

    **UNIVERSITY NAME**

    **CLASS**

    **PROF NAME**

    **DATE**

    **NRNP 6531 i-Human Template / Week 2 Case**

    Management Plan Template

    1. Problem Statement

    a. How would you present this patient to your preceptor? Include both subjective
    and objective findings.

    · Patient is a 36-year-old female with PMH of Type 2 DM, who presents with multiple annular lesions on her bilateral thighs x 2 weeks that she describes as constantly itchy (6/10), characterized by red raised borders, central clearing, and associated erythema and scaling. Denies fever or systemic symptoms. Denies recent travel, exposure to known irritants, new skin products, skin injuries, bites, or infection. Reports worsening of rash with OTC corticosteroid use. Physical exam reveals that the patient is afebrile; lesions are negative for fluctuance, palpable nodules, vesicles, pustules, discharge, or signs of secondary infection. Risk factors include Type 2 DM diagnosis and participation in hot yoga and indoor swimming, making the presentation concerning for a superficial dermatophyte infection.

    2. Primary Diagnosis with coding

    a. Primary diagnosis with ICD-10 code:

    · Tinea Corporis: ICD-10 Code- B35.4

    b. Rationale for primary diagnosis:

    · The clinical presentation of an annular, itchy/pruritic rash on the legs with multiple lesions characterized by raised, erythematous, scaly edges with central clearing and exacerbation with topical corticosteroids use aligns with the AAFP guidelines for diagnosing tinea corporis. (Ely et al., 2014)

    c. CPT Code for Visit:

    · 99213 (Established patient, low complexity visit, problem-focused exam, and decision-making.)

    3. Evidence-based guidelines

    a. Which guidelines were used to develop the primary diagnosis?

    · American Academy of Family Physicians (AAFP) 2014 Clinical Practice Guidelines for diagnosing and managing tinea infections.

    4. Differential Diagnoses

    a. Include 3 -5 differential diagnoses (different from the primary diagnosis):

    · Atopic Dermatitis, Contact Dermatitis, Psoriasis

    b. Rationale for each diagnosis:

    1. Atopic Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, less likely to have active borders or central clearing of lesions that are usually not annular and may be lichenified.

    2. Contact Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, is less likely to have active borders or central clearing, and lesions are usually not annular.

    3. Psoriasis

    · Rationale: Psoriasis can present as well-demarcated, erythematous plaques with silvery scales; however, it lacks central clearing, and lesions tend to persist without spreading in an annular pattern.

    (Ely et al., 2014)

    5. Management Plan: Medications, nonpharmacological treatments, ancillary tests, and referrals:

    a. Drug name, dosage, route. Include any supplements or OTC medications. Include education for prescribed medications:

    · New Rx: Luliconazole 1% cream, apply cream to affected area and 1-inch surrounding area(s) daily for 1 week.

    · Medication Education:

    · Emphasize the importance of applying topical medication 1 inch beyond the border of the lesions.

    · Emphasize the importance of completing the entire course of the topical antifungal regimen to prevent recurrence.

    · Instruct that medication is for topical use only.

    · Instruct not to apply over large surface areas due to the risk of increased systemic exposure.

    (Medscape, 2024)

    · Discontinue OTC corticosteroid cream, as it can worsen tinea infections.

    · OTC antihistamines, like diphenhydramine, as needed for pruritus/itching per package instructions.

    · OTC antifungal powder for prevention.

    b. Nonpharmacological treatment/supportive care:

    · Wash affected areas with mild soap and water, and pat areas dry completely before applying topical medications.

    · Shower, dry the body completely, and wear fresh/clean clothing immediately after activities like yoga or swimming.

    · Aloe Vera can help moisturize and minimize discomfort.

    c. Any ancillary testing needed: None relevant to diagnosis.

    d. Referrals: None relevant to diagnosis.

    6. SDOH, health promotion and risk factors

    a. SDOH – After reviewing this patient’s social history, they do not appear to have any significant SDOH barriers, but here are some important factors to consider.

    · Economic Stability: Assess the affordability of prescription medications.

    · Health Literacy: Ensure understanding of fungal transmission and prevention.

    · Environmental Exposure: Discuss hygiene practices in shared public spaces like gyms and pools.

    b. Health promotion – include all age-appropriate preventive health screenings and immunizations:

    · The patient is currently UTD on the following:

    · Immunizations

    · Dental cleanings

    · Pap smear

    · Annual eye exam

    · Clinical breast exam

    · Additional health promotion screenings needed include:

    · Hemoglobin A1C

    · Lipid panel

    c. Risk factors – Address patient risk factors related to primary diagnosis:

    · Type 2 DM: Impaired immune response related to the disease process of DM predisposes patients to increased risk for dermatophyte infections and impaired wound healing.

    · Exposure to frequent sweating and moist/humid environments: Frequent participation in hot yoga and swimming increases possible exposure to fungi, increasing the susceptibility to dermatophyte infections.

    7. Patient Education

    a. Include comprehensive patient education related to the current health visit:

    · Educate on Diagnosis: Tinea corporis, commonly referred to as "ringworm," is a superficial fungal infection of the legs, arms, or trunk that is treated with consistent antifungal therapy.

    · Transmission Prevention: Avoid sharing towels, clothing, and gym equipment. Keep skin clean and dry. Frequent hand washing. Avoid scratching affected areas if possible.

    · Avoiding Corticosteroids: These medications can worsen fungal/tinea infections.

    · Avoiding excessive moisture: Wear loose-fitting, breathable clothing; change/wash clothing and towels frequently.

    · Disinfect personal items: Clean yoga mats, gym equipment, clothing, and swimwear to prevent reinfection. Do not share items that have not been disinfected, like towels or equipment. Use a separate towel to dry affected areas to avoid spreading the infection.

    · Diagnosis of Type 2 DM as a Risk Factor: Educate on the importance of compliance with disease management and the implications of uncontrolled blood glucose on skin health and its effects on healing, leading to bacterial infections and increased risk for fungal infections.

    8. Follow up

    a. Include time for the next visit and specific symptoms to prompt a return visit sooner:

    · Routine Follow-Up: Schedule in 2 weeks to assess treatment response.

    · Return Sooner If (Red-Flag symptoms):

    · Symptoms worsen despite treatment.

    · New lesions begin to develop.

    · Presence of fever, or if any lesions develop signs of infection like excessive redness, swelling, pain, warmth, or drainage. Go to the emergency room if symptoms are severe.

    · Any adverse reaction to prescribed medications. Go to the emergency room if symptoms are severe, like throat swelling or shortness of breath.

    9. References

    Ely, J. W., Rosenfeld, S., & Stone, M. S. (2014). Diagnosis and Management of Tinea Infections.
    _American Family Physician_,
    _90_(10), 702–711.
    [https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html](https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html)

    _Luzu_. (2024, July 15). Medscape.com. Accessed on March 8, 2025, from https://reference.medscape.com/drug/luzu-luliconazole-999891

    Dermatophyte (tinea) infections. (2025). Uptodate.com. Accessed on March 8, 2025, from https://www.uptodate.com/contents/dermatophyte-tinea-infections?search=tinea%20corporis&source=search_result&selectedTitle=2%7E43&usage_type=default&display_rank=2#H18300298

    Yee, G., Aboud, A. A., & Syed, H. (2025, February 14).
    _Tinea Corporis_. StatPearls. https://www.statpearls.com/point-of-care/30206#History%20and%20Physical

    **ihuman9instructions.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/ihuman9instructions-docx)

    **ihuman9instructions.docx**

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    **## IHUMANTEMPLATE1.docx**

    **NAME**

    **UNIVERSITY NAME**

    **CLASS**

    **PROF NAME**

    **DATE**

    **NRNP 6531 i-Human Template / Week 2 Case**

    Management Plan Template

    1. Problem Statement

    a. How would you present this patient to your preceptor? Include both subjective
    and objective findings.

    · Patient is a 36-year-old female with PMH of Type 2 DM, who presents with multiple annular lesions on her bilateral thighs x 2 weeks that she describes as constantly itchy (6/10), characterized by red raised borders, central clearing, and associated erythema and scaling. Denies fever or systemic symptoms. Denies recent travel, exposure to known irritants, new skin products, skin injuries, bites, or infection. Reports worsening of rash with OTC corticosteroid use. Physical exam reveals that the patient is afebrile; lesions are negative for fluctuance, palpable nodules, vesicles, pustules, discharge, or signs of secondary infection. Risk factors include Type 2 DM diagnosis and participation in hot yoga and indoor swimming, making the presentation concerning for a superficial dermatophyte infection.

    2. Primary Diagnosis with coding

    a. Primary diagnosis with ICD-10 code:

    · Tinea Corporis: ICD-10 Code- B35.4

    b. Rationale for primary diagnosis:

    · The clinical presentation of an annular, itchy/pruritic rash on the legs with multiple lesions characterized by raised, erythematous, scaly edges with central clearing and exacerbation with topical corticosteroids use aligns with the AAFP guidelines for diagnosing tinea corporis. (Ely et al., 2014)

    c. CPT Code for Visit:

    · 99213 (Established patient, low complexity visit, problem-focused exam, and decision-making.)

    3. Evidence-based guidelines

    a. Which guidelines were used to develop the primary diagnosis?

    · American Academy of Family Physicians (AAFP) 2014 Clinical Practice Guidelines for diagnosing and managing tinea infections.

    4. Differential Diagnoses

    a. Include 3 -5 differential diagnoses (different from the primary diagnosis):

    · Atopic Dermatitis, Contact Dermatitis, Psoriasis

    b. Rationale for each diagnosis:

    1. Atopic Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, less likely to have active borders or central clearing of lesions that are usually not annular and may be lichenified.

    2. Contact Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, is less likely to have active borders or central clearing, and lesions are usually not annular.

    3. Psoriasis

    · Rationale: Psoriasis can present as well-demarcated, erythematous plaques with silvery scales; however, it lacks central clearing, and lesions tend to persist without spreading in an annular pattern.

    (Ely et al., 2014)

    5. Management Plan: Medications, nonpharmacological treatments, ancillary tests, and referrals:

    a. Drug name, dosage, route. Include any supplements or OTC medications. Include education for prescribed medications:

    · New Rx: Luliconazole 1% cream, apply cream to affected area and 1-inch surrounding area(s) daily for 1 week.

    · Medication Education:

    · Emphasize the importance of applying topical medication 1 inch beyond the border of the lesions.

    · Emphasize the importance of completing the entire course of the topical antifungal regimen to prevent recurrence.

    · Instruct that medication is for topical use only.

    · Instruct not to apply over large surface areas due to the risk of increased systemic exposure.

    (Medscape, 2024)

    · Discontinue OTC corticosteroid cream, as it can worsen tinea infections.

    · OTC antihistamines, like diphenhydramine, as needed for pruritus/itching per package instructions.

    · OTC antifungal powder for prevention.

    b. Nonpharmacological treatment/supportive care:

    · Wash affected areas with mild soap and water, and pat areas dry completely before applying topical medications.

    · Shower, dry the body completely, and wear fresh/clean clothing immediately after activities like yoga or swimming.

    · Aloe Vera can help moisturize and minimize discomfort.

    c. Any ancillary testing needed: None relevant to diagnosis.

    d. Referrals: None relevant to diagnosis.

    6. SDOH, health promotion and risk factors

    a. SDOH – After reviewing this patient’s social history, they do not appear to have any significant SDOH barriers, but here are some important factors to consider.

    · Economic Stability: Assess the affordability of prescription medications.

    · Health Literacy: Ensure understanding of fungal transmission and prevention.

    · Environmental Exposure: Discuss hygiene practices in shared public spaces like gyms and pools.

    b. Health promotion – include all age-appropriate preventive health screenings and immunizations:

    · The patient is currently UTD on the following:

    · Immunizations

    · Dental cleanings

    · Pap smear

    · Annual eye exam

    · Clinical breast exam

    · Additional health promotion screenings needed include:

    · Hemoglobin A1C

    · Lipid panel

    c. Risk factors – Address patient risk factors related to primary diagnosis:

    · Type 2 DM: Impaired immune response related to the disease process of DM predisposes patients to increased risk for dermatophyte infections and impaired wound healing.

    · Exposure to frequent sweating and moist/humid environments: Frequent participation in hot yoga and swimming increases possible exposure to fungi, increasing the susceptibility to dermatophyte infections.

    7. Patient Education

    a. Include comprehensive patient education related to the current health visit:

    · Educate on Diagnosis: Tinea corporis, commonly referred to as "ringworm," is a superficial fungal infection of the legs, arms, or trunk that is treated with consistent antifungal therapy.

    · Transmission Prevention: Avoid sharing towels, clothing, and gym equipment. Keep skin clean and dry. Frequent hand washing. Avoid scratching affected areas if possible.

    · Avoiding Corticosteroids: These medications can worsen fungal/tinea infections.

    · Avoiding excessive moisture: Wear loose-fitting, breathable clothing; change/wash clothing and towels frequently.

    · Disinfect personal items: Clean yoga mats, gym equipment, clothing, and swimwear to prevent reinfection. Do not share items that have not been disinfected, like towels or equipment. Use a separate towel to dry affected areas to avoid spreading the infection.

    · Diagnosis of Type 2 DM as a Risk Factor: Educate on the importance of compliance with disease management and the implications of uncontrolled blood glucose on skin health and its effects on healing, leading to bacterial infections and increased risk for fungal infections.

    8. Follow up

    a. Include time for the next visit and specific symptoms to prompt a return visit sooner:

    · Routine Follow-Up: Schedule in 2 weeks to assess treatment response.

    · Return Sooner If (Red-Flag symptoms):

    · Symptoms worsen despite treatment.

    · New lesions begin to develop.

    · Presence of fever, or if any lesions develop signs of infection like excessive redness, swelling, pain, warmth, or drainage. Go to the emergency room if symptoms are severe.

    · Any adverse reaction to prescribed medications. Go to the emergency room if symptoms are severe, like throat swelling or shortness of breath.

    9. References

    Ely, J. W., Rosenfeld, S., & Stone, M. S. (2014). Diagnosis and Management of Tinea Infections.
    _American Family Physician_,
    _90_(10), 702–711.
    [https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html](https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html)

    _Luzu_. (2024, July 15). Medscape.com. Accessed on March 8, 2025, from https://reference.medscape.com/drug/luzu-luliconazole-999891

    Dermatophyte (tinea) infections. (2025). Uptodate.com. Accessed on March 8, 2025, from https://www.uptodate.com/contents/dermatophyte-tinea-infections?search=tinea%20corporis&source=search_result&selectedTitle=2%7E43&usage_type=default&display_rank=2#H18300298

    Yee, G., Aboud, A. A., & Syed, H. (2025, February 14).
    _Tinea Corporis_. StatPearls. https://www.statpearls.com/point-of-care/30206#History%20and%20Physical

    **ihuman9instructions.docx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/ihuman9instructions-docx)

    **## IHUMANTEMPLATE1.docx**

    **NAME**

    **UNIVERSITY NAME**

    **CLASS**

    **PROF NAME**

    **DATE**

    **NRNP 6531 i-Human Template / Week 2 Case**

    Management Plan Template

    1. Problem Statement

    a. How would you present this patient to your preceptor? Include both subjective
    and objective findings.

    · Patient is a 36-year-old female with PMH of Type 2 DM, who presents with multiple annular lesions on her bilateral thighs x 2 weeks that she describes as constantly itchy (6/10), characterized by red raised borders, central clearing, and associated erythema and scaling. Denies fever or systemic symptoms. Denies recent travel, exposure to known irritants, new skin products, skin injuries, bites, or infection. Reports worsening of rash with OTC corticosteroid use. Physical exam reveals that the patient is afebrile; lesions are negative for fluctuance, palpable nodules, vesicles, pustules, discharge, or signs of secondary infection. Risk factors include Type 2 DM diagnosis and participation in hot yoga and indoor swimming, making the presentation concerning for a superficial dermatophyte infection.

    2. Primary Diagnosis with coding

    a. Primary diagnosis with ICD-10 code:

    · Tinea Corporis: ICD-10 Code- B35.4

    b. Rationale for primary diagnosis:

    · The clinical presentation of an annular, itchy/pruritic rash on the legs with multiple lesions characterized by raised, erythematous, scaly edges with central clearing and exacerbation with topical corticosteroids use aligns with the AAFP guidelines for diagnosing tinea corporis. (Ely et al., 2014)

    c. CPT Code for Visit:

    · 99213 (Established patient, low complexity visit, problem-focused exam, and decision-making.)

    3. Evidence-based guidelines

    a. Which guidelines were used to develop the primary diagnosis?

    · American Academy of Family Physicians (AAFP) 2014 Clinical Practice Guidelines for diagnosing and managing tinea infections.

    4. Differential Diagnoses

    a. Include 3 -5 differential diagnoses (different from the primary diagnosis):

    · Atopic Dermatitis, Contact Dermatitis, Psoriasis

    b. Rationale for each diagnosis:

    1. Atopic Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, less likely to have active borders or central clearing of lesions that are usually not annular and may be lichenified.

    2. Contact Dermatitis

    · Rationale: Also has erythematous/itchy lesions/plaques, is less likely to have active borders or central clearing, and lesions are usually not annular.

    3. Psoriasis

    · Rationale: Psoriasis can present as well-demarcated, erythematous plaques with silvery scales; however, it lacks central clearing, and lesions tend to persist without spreading in an annular pattern.

    (Ely et al., 2014)

    5. Management Plan: Medications, nonpharmacological treatments, ancillary tests, and referrals:

    a. Drug name, dosage, route. Include any supplements or OTC medications. Include education for prescribed medications:

    · New Rx: Luliconazole 1% cream, apply cream to affected area and 1-inch surrounding area(s) daily for 1 week.

    · Medication Education:

    · Emphasize the importance of applying topical medication 1 inch beyond the border of the lesions.

    · Emphasize the importance of completing the entire course of the topical antifungal regimen to prevent recurrence.

    · Instruct that medication is for topical use only.

    · Instruct not to apply over large surface areas due to the risk of increased systemic exposure.

    (Medscape, 2024)

    · Discontinue OTC corticosteroid cream, as it can worsen tinea infections.

    · OTC antihistamines, like diphenhydramine, as needed for pruritus/itching per package instructions.

    · OTC antifungal powder for prevention.

    b. Nonpharmacological treatment/supportive care:

    · Wash affected areas with mild soap and water, and pat areas dry completely before applying topical medications.

    · Shower, dry the body completely, and wear fresh/clean clothing immediately after activities like yoga or swimming.

    · Aloe Vera can help moisturize and minimize discomfort.

    c. Any ancillary testing needed: None relevant to diagnosis.

    d. Referrals: None relevant to diagnosis.

    6. SDOH, health promotion and risk factors

    a. SDOH – After reviewing this patient’s social history, they do not appear to have any significant SDOH barriers, but here are some important factors to consider.

    · Economic Stability: Assess the affordability of prescription medications.

    · Health Literacy: Ensure understanding of fungal transmission and prevention.

    · Environmental Exposure: Discuss hygiene practices in shared public spaces like gyms and pools.

    b. Health promotion – include all age-appropriate preventive health screenings and immunizations:

    · The patient is currently UTD on the following:

    · Immunizations

    · Dental cleanings

    · Pap smear

    · Annual eye exam

    · Clinical breast exam

    · Additional health promotion screenings needed include:

    · Hemoglobin A1C

    · Lipid panel

    c. Risk factors – Address patient risk factors related to primary diagnosis:

    · Type 2 DM: Impaired immune response related to the disease process of DM predisposes patients to increased risk for dermatophyte infections and impaired wound healing.

    · Exposure to frequent sweating and moist/humid environments: Frequent participation in hot yoga and swimming increases possible exposure to fungi, increasing the susceptibility to dermatophyte infections.

    7. Patient Education

    a. Include comprehensive patient education related to the current health visit:

    · Educate on Diagnosis: Tinea corporis, commonly referred to as "ringworm," is a superficial fungal infection of the legs, arms, or trunk that is treated with consistent antifungal therapy.

    · Transmission Prevention: Avoid sharing towels, clothing, and gym equipment. Keep skin clean and dry. Frequent hand washing. Avoid scratching affected areas if possible.

    · Avoiding Corticosteroids: These medications can worsen fungal/tinea infections.

    · Avoiding excessive moisture: Wear loose-fitting, breathable clothing; change/wash clothing and towels frequently.

    · Disinfect personal items: Clean yoga mats, gym equipment, clothing, and swimwear to prevent reinfection. Do not share items that have not been disinfected, like towels or equipment. Use a separate towel to dry affected areas to avoid spreading the infection.

    · Diagnosis of Type 2 DM as a Risk Factor: Educate on the importance of compliance with disease management and the implications of uncontrolled blood glucose on skin health and its effects on healing, leading to bacterial infections and increased risk for fungal infections.

    8. Follow up

    a. Include time for the next visit and specific symptoms to prompt a return visit sooner:

    · Routine Follow-Up: Schedule in 2 weeks to assess treatment response.

    · Return Sooner If (Red-Flag symptoms):

    · Symptoms worsen despite treatment.

    · New lesions begin to develop.

    · Presence of fever, or if any lesions develop signs of infection like excessive redness, swelling, pain, warmth, or drainage. Go to the emergency room if symptoms are severe.

    · Any adverse reaction to prescribed medications. Go to the emergency room if symptoms are severe, like throat swelling or shortness of breath.

    9. References

    Ely, J. W., Rosenfeld, S., & Stone, M. S. (2014). Diagnosis and Management of Tinea Infections.
    _American Family Physician_,
    _90_(10), 702–711.
    [https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html](https://www.aafp.org/pubs/afp/issues/2014/1115/p702.html)

    _Luzu_. (2024, July 15). Medscape.com. Accessed on March 8, 2025, from https://reference.medscape.com/drug/luzu-luliconazole-999891

    Dermatophyte (tinea) infections. (2025). Uptodate.com. Accessed on March 8, 2025, from https://www.uptodate.com/contents/dermatophyte-tinea-infections?search=tinea%20corporis&source=search_result&selectedTitle=2%7E43&usage_type=default&display_rank=2#H18300298

    Yee, G., Aboud, A. A., & Syed, H. (2025, February 14).
    _Tinea Corporis_. StatPearls. https://www.statpearls.com/point-of-care/30206#History%20and%20Physical

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  • [Solved] HIT 2200 MOD 2 DB

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    1. Review the 5 individual rights guaranteed by the HIPAA Privacy Rule. 2. Have you or someone close to you utilized any of the 5 rights? 3. What are some circumstances when you would want to utilize each of the 5 rights? – a year ago

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    1. Review the 5 individual rights guaranteed by the HIPAA Privacy Rule.
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    3. What are some circumstances when you would want to utilize each of the 5 rights?

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  • [Solved] HIT 2200 MOD 2 ASSN

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    Read "M2 Dimick Sorting out Advance Directives_Journal of AHIMA HL.pdf" attached above. You are a Medical Records Technician at Northwestern Memorial Hospital. One of your tasks is applying applicable laws, policies, and procedures for ROI. For each scenario, describe the decision you render. Answe…

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    Read "M2 Dimick Sorting out Advance Directives_Journal of AHIMA HL.pdf" attached above. You are a Medical Records Technician at Northwestern Memorial Hospital.  One of your tasks is applying applicable laws, policies, and procedures for ROI. For each scenario, describe the decision you render.  Answer the two questions that follow.

    [M2 Dimick Sorting out Advance Directives _ Journal of AHIMA HL.pdf](https://indianatech.instructure.com/courses/22412/files/4053717/download?download_frd=1 "Link") [Download M2 Dimick Sorting out Advance Directives _ Journal of AHIMA HL.pdf](https://indianatech.instructure.com/courses/22412/files/4053717/download?download_frd=1) [Open this document with ReadSpeaker docReader](https://docreader.readspeaker.com/docreader/?cid=11574&lang=en_us&url=https%3A%2F%2Finst-fs-pdx-prod.inscloudgate.net%2Ffiles%2F414db40d-05e2-448e-8adf-856a2e8c09db%2FM2%2520Dimick%2520Sorting%2520out%2520Advance%2520Directives%2520_%2520Journal%2520of%2520AHIMA%2520HL.pdf%3Ftoken%3DeyJ0eXAiOiJKV1QiLCJhbGciOiJIUzUxMiJ9.eyJpYXQiOjE3NDU0MzU3NTksInVzZXJfaWQiOm51bGwsInJlc291cmNlIjoiL2ZpbGVzLzQxNGRiNDBkLTA1ZTItNDQ4ZS04YWRmLTg1NmEyZThjMDlkYi9NMiUyMERpbWljayUyMFNvcnRpbmclMjBvdXQlMjBBZHZhbmNlJTIwRGlyZWN0aXZlcyUyMF8lMjBKb3VybmFsJTIwb2YlMjBBSElNQSUyMEhMLnBkZiIsImp0aSI6ImViYzE5OWE5LWNlMjctNDcxNS05ODU2LWI1M2IzNGFjMGYwOCIsImhvc3QiOm51bGwsImV4cCI6MTc0NTUyMjE1OX0.ONvQXLaiPK58UdT4ADcxXyjWQYTKs6pLBVGxpHNWV5xPgCLYQMejVFRyelc67AcOP0VJYrBxsSn4fgYD22y65Q "Open this document with ReadSpeaker docReader")

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    – [\
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    The patient presented to the clinic to establish care and get weight loss medication. This is a comprehensive soap note powerpoint. the primary diagnosis of thyroiditis with the patient request being secondary. The patient 51 year old female has a history of Hashimoto thyroiditis (diagnosed in 2013)…

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    The patient presented to the clinic to establish care and get weight loss medication. This is a comprehensive soap note powerpoint.

    the primary diagnosis of thyroiditis with the patient request being secondary.

    The patient 51 year old female has a history of Hashimoto thyroiditis (diagnosed in 2013), IBS (diagnosed in 2006) and was requesting weight loss medication.

    appropriately cites a requisite number of references. **At least 10 peer-reviewed evidence-based references dated within the last 5 years (unless classic research or current clinical practice guidelines). Citations on each slide. prepare a case study with four related discussion questions at the end of the presentation. (with rationale for answers to the presentation questions)**

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    Slide 2 CC: Chief Complaint in Quotations

    Slide 3 HPI: History of Present Illness

    Slide 4 ROS: Review of Systems

    Slide 5 Relevant History

    Slide 6 Allergies

    Slide 7 Current Medications

    Slide 8 Physical and Psychological Assessment

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    Slide 10 Infographics

    Slide 11 Final Diagnosis (most likely diagnosis) and rationale

    Slide 12 Pathophysiology of my likely diagnosis (short and concise)

    Slide 13 Charts and graphs

    Slide 14 Labs and diagnostic studies (include results to confirm the most likely diagnosis)

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    Slide 16 Patient Education

    Slide 17 4 Questions & Answers with rationales. Citations per answer.

    Slide 18 References in APA 7th edition format.  No consumer websites. Include clinical practice guidelines as appropriate and references within five years (unless classic research).

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    ·  Choose the appropriate font, size, and color.

    ·  Use transitions that work with your presentation.

    ·  Make the charts and graphs understandable.

    ·  Use infographics.

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    In-depth study guidance and analytical solution covering What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?.

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    **Application of Course Knowledge:** Answer all questions/criteria with explanations and detail. 1. Reflect on your learning experience in this course. Which concepts stood out to you and made an impact? How do you envision using these concepts in your future nursing practice as a master’s prepared …

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    **Application of Course Knowledge:** Answer all questions/criteria with explanations and detail.

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