NR 511 Week 2 iHuman Virtual Patient Encounter Attempt 3659465 - Krista Hampton

History Notecard by Briayanna Nordwick on case Krista Hampton Use this worksheet to organize your thoughts before developing a differential diagnosis list. 1. Indicate key symptoms (Sx) you have identified from the history. Start with the patient's reason(s) for the encounter and add additional symptoms obtained from further questioning. 2. Characterize the attributes of each symptom using "OLDCARTS". Capture the details in the appropriate column and row. 3. Review your findings and consider possible diagnoses that may correlate with these symptoms. (Remember to consider the patient's age and risk factors.) Use your ideas to help guide your physical examination in the next section of the case. HPI Sx = Rash Sx Sx Sx Sx Sx = = = = = Onset 2 days ago Location “Started on my inner thighs, now it's on my left inner forearm” Duration Constant Characteristics “Uncomfortable, itchy and tender” Aggravating “I haven't tried anything yet” Relieving “I haven't tried anything yet” Timing / Denies any treatments/home remedies Treatments Severity “I don't really know how to judge that” Attempt: 3659465 Report generated on 9/14/2025, 1:02:00 PM America/Denver Management Plan by Briayanna Nordwick on case Krista Hampton Tests/Diagnostics No routine testing is necessary to confirm allergic contact dermatitis, as this is a clinical diagnosis based on history and exam. However, if her rash worsens, spreads rapidly, or if fever and systemic symptoms develop, bacterial cultures of vesicular fluid or a wound swab may be indicated to evaluate for cellulitis or secondary infection. Allergy testing such as patch testing may be helpful in the future if she develops recurrent rashes or if specific allergen identification is required. At present, diagnostic testing is not needed, but the patient should be closely monitored for changes. Plan of Care Pharmacologic: Prescribe a medium- to high-potency topical corticosteroid (triamcinolone 0.1% cream and/or 1% Hydrocortisone cream) to reduce inflammation and itching. Recommend an oral antihistamine such as cetirizine or diphenhydramine (Benadryl 25mg PO) for pruritus and to aid sleep if nighttime itching is disruptive. (Reserve systemic corticosteroids for cases of extensive or worsening dermatitis.) Non-Pharmacologic: Apply cool compresses to relieve itching and discomfort. Wash skin, clothing, and bedding thoroughly to remove any residual plant oils. Keep nails trimmed and avoid scratching to minimize secondary infection risk. Avoid scratching Patient Education: Educate the patient on avoiding suspected plant exposures during future outdoor activity. Advise testing new sunscreens or skin products on a small patch of skin prior to full use. Review warning signs of infection such as increasing pain, spreading redness, pus, or fever, and instruct her to seek immediate medical attention if these occur. Follow-Up: Reassess if symptoms worsen, fail to improve within 7–10 days, or if systemic signs develop. Consider dermatology referral and patch testing if recurrent rashes occur or if diagnosis remains unclear. References Dickel, H. (2023). Management of contact dermatitis. Allergo Journal International, 32(3), 57-76. Li, Y., & Li, L. (2021). Contact dermatitis: classifications and management. Clinical reviews in allergy & immunology, 61(3), 245-281. Patel, K., & Nixon, R. (2022).