NR 576 Week 2 i-Human Virtual Patient Encounter Attempt 3916714 - Victoria Lewis

History Notecard by Evana Loera on case Victoria Lewis 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 36hrs Location Inner thighs and left inner forearm Duration Constant Characteristics itching and tender Aggravating None Relieving None Timing / Treatments None Severity Unknown Attempt: 3916714 Report generated on 5/17/2026, 10:34:33 PM America/Denver Management Plan by Evana Loera on case Victoria Lewis Management Plan 1. Diagnostic Tests: Testing at this visit is not needed. However if symptoms continue despite treatment, and additional symptoms that raise the concern for dermatomyositis, then testing will be considered. 2. Medications: Triamcinolone Triamcinolone Acetonide 0.1% cream Sig: Apply a thin layer to affected area(s) twice daily for 7–14 days as needed for rash and itching. Avoid face, groin, and axilla. Dispense: 30 g tube Refills: 0 Rationale: helps decrease redness, inflammation, and itching from the rash. Usually used short term because it is a very strong steroid cream. (Lurati, 2026) Zyrtec (Cetirizine) 10 mg tablets (do not take if taking Claritin) Sig: Take 1 tablet by mouth once daily as needed for allergies or itching. Dispense: 30 tablets Refills: 0 (OTC) Rationale: help control itching and allergic symptoms during the day. (Lurati, 2026) Claritin (Loratadine) 10 mg tablets (do not take if taking Zyrte) Sig: Take 1 tablet by mouth once daily as needed for allergy symptoms. Dispense: 30 tablets Refills: 0 (OTC) Rationale: help control itching and allergic symptoms during the day. (Lurati, 2026) Benadryl (Diphenhydramine) 25 mg capsules Sig: Take 1 capsule by mouth every 6 hours as needed for itching or allergic reaction. Dispense: 20 capsules Refills: 0 (OTC) Rationale: often used at night because it can make the patient sleepy and help with nighttime itching. (Lurati, 2026) Medrol Dose Pack Medrol Dose Pack 4 mg tablets Sig: Take by mouth as directed on dose pack over 6 days for contact dermatitis. Take with food. Dispense: 1 dose pack Refills: 0 Rationale: Help to suppress the inflammatory response. (Lurati, 2026) 3. Suggested Consults/ Referrals: None indicated at this time. Will consider Dermatologist subspecialist referral for recurrent/ worsening symptoms. (Wikström 2025) 4. Client Education: Clinical exam findings of contact dermatitis were discussed with patient Patient advised to continue the OTC Zyrtec or Claritin to help control itching and allergic symptoms during the day. Patient advised to continue with Benadryl at night as needed to nighttime itching. Avoid the trigger/irritant if known (soap,