Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.  

ASC Discussion:

What are the characteristics of papulosquamous eruptions? Be thorough and descriptive.

Papulosquamous eruptions are skin lesions that appear as red or purple papules or plaques with scale. These conditions are characterized by severe scaling or flaking as a result of epidermal inflammation or proliferation. Psoriasis, pityriasis rosea, tinea corporis, lichen planus, pityriasis lichenoides, dermatomyositis, lupus erythematous, pityriasis rubra pilaris, and secondary syphilis are all examples of papulosquamous eruptions in youngsters (Bunik, 2020).

What are the common conditions associated with papulosquamous eruptions in children? List at least 3 common conditions and include the pathophysiology of each condition.

Pityriasis Rosea is a widespread, moderate, and self-limiting papulosquamous illness characterized by a rose-colored flaking rash. The etiology is unknown, although whether it is caused by humans herpesvirus 6 or 7. Mildly contagious and tends to occur most commonly in fall, winter, and spring.

Physical Exam- Herald spot or patch meaning 2 to 5 cm solidary, ovoid, erythematous lesion with finely scaled elevated border that enlarges quickly with central clearing. Most herald patches appear on the trunk, upper arm, neck, or thigh. Pityriasis rosea also known for the Christmas tree pattern rash. The rash on the patient’s back follows dermatome skin lines with oval lesions running parallel and wrapping around to the trunk.

Psoriasis is a persistent papulosquamous skin disease involving remissions and flare-ups. The patient will have thick silvery scales, a variety of distribution patterns, and an isomorphic reaction. The skin condition is an immune-mediated disease with an unclear origin.
Physical examination and important findings- Plaque psoriasis, guttate (tear drop) psoriasis, psoriasis vulgaris, Koebner phenomenon, Auspitz sign, Nail signs, and diaper area psoriasis are some of the many kinds and important findings.

Lichen Striatus- the patient will present with unilateral shiny papules along embryonic lines or lines of Blaschko that typically appears on extremities, upper back, neck, palms, soles, nails, genitals, or face. The rash is more common in school-age child affecting more girls than boys. Rash is benign, noncontagious, and self-limited. 

What are the appropriate treatments for common papulosquamous eruptions? Why?

Sun exposure or phototherapy are effective treatments for pityriasis rosea, one of the most frequent papulosquamous eruptions. This is due to the fact that sun exposure or phototherapy lowers pruritus and speeds up resolution. Furthermore, topical corticosteroids of moderate-to-high potency, typically in conjunction with topical calcipotriene (Dovonex) twice a day for 1 to 3 months, are used to treat guttate psoriasis, the most prevalent psoriasis (Bajaj & Berman, 2017).

When should children with papulosquamous eruptions be referred to a dermatologist?

If a child’s rash worsens or does not improve with observation or empiric therapy, he or she should see a dermatologist. Mycosis fungoides, for example, mimics eczema in its early stages and is seldom accurately identified at first presentation. In persistent eczematous diseases that do not respond to treatment, reevaluation and potential referral are essential.

Define the following: a) confluent, b) papular, c) papulosquamous, and d) rhinorrhea

Confluent: refers to some skin lesions that combine to form a patch.

Papular refers to a tiny raised, sensitive lump on the skin.
Papulosquamous: a category of skin diseases distinguished by red, raised, scaly patches with well-defined boundaries.
Rhinorrhea: often known as a runny nose, refers to excessive drainage from the nose and nasal passages, which can range from clear fluid to thick mucus.

Reference:

Andrews, S. (2021). What is the pathophysiology of tinea infections? Medscape.com. https://www.medscape.com/answers/787217-157242/what-is-the-pathophysiology-of-tineainfections

 

In a reflective journal, answer the following questions and submit to Canvas.

• What are some of the considerations that Alena and her family might be struggling with as the weigh benefits versus risks of brain surgery?
• Do you feel that Alena is satisfied with her decision? Is her mother? Her sister? Why or why not?
• Alena’s mother is seen at the end of the vignette asking herself “is it worth it? I don’t know.” How does Alena seem to feel regarding her outcomes?

 Chapter 39, Assessment and Management of Patients With Rheumatic Disorders

1. Ellie Long, a 55-year-old patient, presents to the pain clinic with the diagnosis of fibromyalgia syndrome. The nurse at the clinic obtains a history and physical assessment of the patient. (Learning Objective 2)

1. On what areas should the nurse concentrate when interviewing the patient during the history process?
2. On what areas should the nurse concentrate when assessing the patient?
3. What diagnostic tests are used with fibromyalgia syndrome?

2. Julie Walker, a 22-year-old patient, is newly diagnosed with systemic lupus erythematosus (SLE). She presented with extreme fatigue; muscle and joint aching and swelling; a butterfly-shaped, flat, red rash across the bridge of the nose; patchy alopecia; a low-grade fever; and loss of appetite. Further workup revealed a positive antinuclear antibodies (ANA) titer, anemia, leucopenia, and mild thrombocytopenia. She has an abnormal lipid profile, proteinuria, and hypertension. The liver and renal profiles are within normal range. The physician ordered over-the-counter ibuprofen as needed for joint discomfort, but not to exceed 1,200 mg/day; hydroxychloroquine sulfate (Plaquenil) before meals at the same time each day; and prednisone in tapering doses over the next month. The physician also started the patient on lisinopril, an ACE inhibitor for the hypertension and a statin for the elevated lipids. The clinic nurse is asked by the physician to provide patient and family education. (Learning Objective 5) 

1. What teaching-plan topics should the nurse provide for the patient?

 Search the web to research what patient outcomes are negatively impacted by nursing staff reduction. After you have found the necessary information, please write a short response (4-5 sentences) answering the question below.   

   After researching the impact of patient outcomes and nursing ratios, what conclusion did you come to?     Were your findings expected, or were there startling discoveries made in the midst of your research?