I-Human Exam: Performance Overview For Jessica Rhyan On Case Gemma Jones

I-HUMAN EXAM: Performance Overview for Jessica Rhyan on case Gemma Jones Thefollowingtablesummarizesyourperformanceoneachsectionofthecase,whetheryoucompletedthatsectionornot.Timespent:7hr30min57secStatus:SubmittedCaseSectionStatusYo u rScoreTimespentPerformanceDetailsTo t a lScore100%HistoryDone100%8min54sec17questionsasked,16correct,0missedrelativetothecase'slistPhysicalexamsDone100%11min53sec23examsperformed,13correct,0partiallycorrect,0missedrelativetothecase'slistKeyQindingsorganizationDone8min22sec4Qindingslisted;5listedbythecaseProblemstatementDone14min0sec75wordslong;thecase'swas76wordsDifferentialsDone100%6min30sec5itemsintheDDx,5correct,0missedrelativetothecase'slistDifferentialsrankingDone100%(lead/altscore)0%(mustnotmissscore)1hr6min59secTestsDone100%2hr39min4sec0testsordered,0correct,0missedrelativetothecase'slistDiagnosisDone100%10secManagementplanDone54min33sec238wordslong;thecase'swas37wordsHistoryNotecardbyJessicaRhyanoncaseGemmaJonesUsethisworksheettoorganizeyourthoughtsbeforedevelopingadifferentialdiagnosislist.1.Indicatekeysymptoms(Sx)youhaveidentiQiedfromthehistory.Startwiththepatient'sreason(s)fortheencounterandaddadditionalsymptomsobtainedfromfurtherquestioning.2.Characterizetheattributesofeachsymptomusing"OLDCARTS".Capturethedetailsintheappropriatecolumnandrow.3.ReviewyourQindingsandconsiderpossiblediagnosesthatmaycorrelatewiththesesymptoms.(Remembertoconsiderthepatient'sageandriskfactors.)Useyourideastohelpguideyourphysicalexaminationinthenextsectionofthecase.HPISx=Sx=Sx=Sx=Sx=Sx=OnsetLocationDurationCharacteristicsAggravatingRelievingTiming/TreatmentsSeverityProblemStatementbyJessicaRhyanoncaseGemmaJonesGemmaJonesisa2-year-oldgirlwhopresents,accompaniedbyhermother,forarashthatstartedonherabdomenthismorningandspreadtoherbilateralupperandlowerextremities.Motherreportscough,rhinorrhea,andfeverthatstartedthreedaysagoandthefeversubsidedlastnight.Motherdenieschangeinwet/dirtydiapers.Physicalexamrevealsmaculopapularpinkrash,withouterythematouspharynxandadventitiousbreathsounds.Patientisuptodateonallimmunizations.ManagementPlanbyJessicaRhyanoncaseGemmaJonesDiagnostictests-nodiagnostictestsneeded.CouldcheckIgMforacuteillness,butnotnecessary(Baketal.,2017).Medications-AccordingtoEpocrates:OTCTylenolSuspension5mLPOevery4-6hoursasneededforfeverOTCChildren'sAdvilsuspension5mLPOevery6-8hoursasneededforfeverSuggestedconsults/referrals-Thisisaclinicallydiagnosed,self-limitedillnessthatcanbetreatedsymptomatically,thisnoreferralisneeded(Hollier,2021,p.227).Clienteducation-Therashshouldresolvewithin24hours.Tylenolandibuprofencanbealternatedforfeverreduction.EnsureyourchildisintakingQluid,makinganormalamountofwetdiapers,andproducestearsifshecries.Allowforplentyofrest.Ta k eallmedicationsasmanufacturerdirectedonthebackofthebox,donotexceedrecommendeddosage.Makesureyoureadalllabelsofothermedicationstonotgivecombinationmedicationsthatcontainacetaminophenoribuprofen.Donotgiveaspirin.Mayreturntodaycareassoonaspossible,sincethefeverbrokelastnight(Hollier,2021,p.227).Follow-up-noneneeded,follow-upasneededResourcesBak,Z.,Arvas,M.H.,Bier,C.,Akay,A.,stebay,S.,&lkerstebay,D.(2017).Evaluationofroseolainfantumcasesintermsofdemographicpropertiesandlaboratoryvalues.JournalofPediatricInfection,11(2),53-59.https://doi.org/10.5578/ced.201717Epocrates.(2022).https://online.epocrates.com/drugsHollier,A.(2021).InClinicalguidelinesinprimarycare(p.227).essay,AdvancedPracticeEducationAssociates.ElectronicHealthRecordbyJessicaRhyanoncaseGemmaJonesHistoryofPresentIllnessPastMedicalHistoryMedicationsAllergiesPreventiveHealthFamilyHistoryCategoryDataenteredbyJessicaRhyanReasonforEncounterRashonabdomenandbilateralupperandlowerextremitiesHistoryofpresentillness2-year-oldGemmaJonespresentstotheofQice,withhermother.Motherstatesthepatienthadafeverforthelast3days,whichstoppedlastevening.Additionally,complainsofcoughandrhinorrheafor3days.Therashstartedonherabdomenthismorningandspreadtoherupperandlowerextremities.MomwasgivingTylenol,basedonthemanufacturerdirections,andstoppedwhenthefeversubsided.CategoryDataenteredbyJessicaRhyanPastMedicalHistoryNoneHospitalizations/Surgeriesbornfullterm38weeksGA,viaNSVDCategoryDataenteredbyJessicaRhyanMedicationsnoneCategoryDataenteredbyJessicaRhyanAllergiesNKDACategoryDataenteredbyJessicaRhyanPreventivehealthgrowinganddevelopingwell-reachingdevelopmentalmilestones.UTDoncurrentvaccinationsCategoryDataenteredbyJessicaRhyanFamilyHistoryMother32-healthyFather35-healthySocialHistoryReviewofSystemsPhysicalExamsCategoryDataenteredbyJessicaRhyanSocialHistoryLivesinanapartmentwithbothparentsCategoryDataenteredbyJessicaRhyanGeneraldeniesfever,weightchange,andchangeinappetiteIntegumentary/BreastadmitstorashonabdomenandupperandlowerextremitiesHEENT/NeckadmitstorhinorrheaandcoughCardiovasculardeniesfatigue,SOBRespiratoryadmitstocough,deniesSOB,wheezing,sputumGastrointestinaldiaperstoolsabouttwoperdayGenitourinaryurinediapers4-5perdayMusculoskeletaldenieschangeinstrengthandrangeofmotionAllergic/ImmunologicEndocrineHematologic/LymphaticdeniesNeurologicdenies,nohistoryofseizurePsychiatricCategoryDataenteredbyJessicaRhyanGenerala/ox4,normalappearance,active,well-developedSkinpinkmaculopapularrashonabdomenandupperandlowerextremitiesHEENT/NeckHead/neck-Normocephalic,fullROMofneck,notendernessEENT-Eyes-PERRLA.Noerythema,drainage,swellingnoted.Ears-Notendernesstopalpation,drainage,erythemaorbulgingtoTMnoted.Nose-Noerythema,drainage,ortendernesstopalpationnoted.Throat-Moist,pink.Noulcers.Normaldentitionandgums.NotonsillarexudateCardiovascularRRR.Nomurmursnoted.NegativeforbilaterallowerextremityedemaChest/RespiratoryChestexpansionissymmetrical.Lungsarecleartoauscultation.AbdomenFlat,symmetric,nodeformitiesGenitourinary/RectalMusculoskeletal/OsteopathicStructuralExaminationNeurologicPsychiatricLymphaticnobleedingorbruisingnoted.Noenlarged,swollenlymphnodesinthecervical,supraclavicular,axillaryandinguinalchains