Advanced assessment: interpreting findings and formulating by Mary Jo Goolsby EdD MSN ANP-C CAE FAANP, Laurie Grubbs

By Mary Jo Goolsby EdD MSN ANP-C CAE FAANP, Laurie Grubbs PhD MSN ANP-C

AJN 2006 Award WinnerUnique in its procedure, this new ebook takes clients past the identity of actual evaluation abnormalities to reach at a differential prognosis of the patient's illness. Readers how to comprise actual exam, sufferer background, and diagnostic stories to properly prognosis a patient's problem.

Incorporates info at the interpretation of evaluate findings

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Signs and Symptoms. The patient often provides the history of recurrent and/or chronic skin changes that most frequently involve the extensor surfaces of extremities and scalp, although other regions are frequently involved. The lesions are described often described as itchy, although this is highly variable. There may be associated concurrent arthralgia. The typical psoriasis lesion has a well-demarcated border, with a silvery colored scale overlying an area of obvious erythema. If the scale is removed, the erythemic base reveals minute bleeding points.

The color atlas (see Plates 1–4) includes photographs of specialized techniques that are helpful in assessing skin lesions: magnification, diascopy, skin scrapings, and the use of Wood’s lamp. DIFFERENTIAL DIAGNOSIS OF COMMON CHIEF COMPLAINTS Note: The color atlas (see Plates 5–32) includes photographs, in alphabetical order, of many of the conditions described in the following section. Vesicles (Blisters) Vesicles (blisters) are small, fluid-filled lesions. They may erupt at a site that initially appears inflamed, with a macule or papule.

There is often complaint of pruritus over scaling areas and pain at any developing fissures. The condition usually involves the interdigital areas, causing maceration, inflammation, and fissures. However, the plantar areas of the feet are prone to developing painful blisters in response to the infection. The vesicles often erode and the patient is then prone to secondary infection. Diagnostic Studies. None needed. Scraping will reveal hyphae. CONTACT DERMATITIS (PLATE 10) Contact dermatitis is an inflammatory response to contact with some chemical or other agent.

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