Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To Prepare

· Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.

· Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?

· Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.

· Consider which of the conditions is most likely to be the correct diagnosis, and why.

· Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.

· Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.

· Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.

The Lab Assignment

Choose one This week you will be submitting your paper in SOAP format.  The template and the grading rubric for this format is located in the Course Info folder.  This is the format approved for this course, so please follow it.  You will be choosing one skin graphic to write your SOAP note. Need to organize your data in this format…..and under “S” you will need to ask your questions…but obviously your patient cannot answer you.  So….under “S”….list all of the questions that you would ask the patient from the template list, including Meds, Allergies, ROS, etc…….think about everything that you would need to know and ask to make a clinical decision.  The “O” is what the condition looks like.  This is the objective piece of the note…..you do not ask the patient questions here, it is just what you observe.    Be specific!!!  Describe the lesion ie:  size, location, characteristics, etc….  think of this as documenting directly in a patient’s chart.  A/P are your list of differentials with rationale on why you chose those diagnosis.  You list them from most likely to least likely.

· This week you will be submitting your paper in SOAP format.  The template and the grading rubric for this format is located in the Course Info folder.  This is the format approved for this course, so please follow it.  You will be choosing one skin graphic to write your SOAP note. Need to organize your data in this format…..and under “S” you will need to ask your questions…but obviously your patient cannot answer you.  So….under “S”….list all of the questions that you would ask the patient from the template list, including Meds, Allergies, ROS, etc…….think about everything that you would need to know and ask to make a clinical decision.  The “O” is what the condition looks like.  This is the objective piece of the note…..you do not ask the patient questions here, it is just what you observe.    Be specific!!!  Describe the lesion ie:  size, location, characteristics, etc….  think of this as documenting directly in a patient’s chart.  A/P are your list of differentials with rationale on why you chose those diagnosis.  You list them from most likely to least likely.

The Assignment: 5 pages

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this      Assignment. Be sure to include the specific patient factors that may      impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and      support your response with clinically relevant and patient-specific      resources, including the primary literature.
• Why did you not select the other two options provided      in the exercise? Be specific and support your response with clinically      relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this      decision? Support your response with evidence and references to the      Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your      treatment plan and communication with patients. Be specific and provide      examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and      support your response with clinically relevant and patient-specific      resources, including the primary literature.
• Why did you not select the other two options provided      in the exercise? Be specific and support your response with clinically      relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this      decision? Support your response with evidence and references to the      Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your      treatment plan and communication with patients. Be specific and provide      examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and      support your response with clinically relevant and patient-specific      resources, including the primary literature.
• Why did you not select the other two options provided      in the exercise? Be specific and support your response with clinically      relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this      decision? Support your response with evidence and references to the      Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your      treatment plan and communication with patients. Be specific and provide      examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options      you selected for this patient. Be sure to justify your recommendations and      support your response with clinically relevant and patient-specific      resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Same drill as your previous decision tree assignment.  Please be sure to incorporate the feedback I provided into this week’s decision tree.

Treating patients with Anxiety Disorders

I want you to answer the questions given to you (decision points one, two, and three) before you click on the option. The answers will be based on your decisions made and patient outcomes during the decision tree. I am looking for an essay that is long enough to cover the topic BUT short enough to keep my interest.  The course page suggests writing 1 page per decision – my opinion is that it will be very difficult to justify your treatment decisions and provide scientific evidence in 1 page (especially for decision #1). I do not need you to tell me about the patient or the treatment options available to you – I am very familiar with the cases.  Your introductory page should be an overview of the disease state you are treating along with a purpose statement for the assignment.  Remember this is a Pharmacology class that incorporates Pharmacotherapy and not a class on diagnosing disease. I want you to tell me why you selected an option (why is it the best option- using clinically relevant and patient specific data) AND why you did not choose the other options (with clinically relevant and patient specific data).