For this week, we continue with the dermatology case study covered in Week 5. For this week discussion, you are not required to respond to your peers. Responses must be supported by peer-reviewed references, and in APA 6th ed format. DERMATOLOGY CASE STUDY Chief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”. HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief. She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills.  PMH: Diabetes Mellitus, type 2. Surgeries: None Allergies: Augmentin Medication: Metformin 500mg PO BID. Vaccination History: Immunization is up to date and she received her flu shot this year. Social history: College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago. Family history: Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN. ROS: Constitutional: Negative for fever. Negative for chills. Respiratory: No Shortness of breath. No Orthopnea Cardiovascular: Regular rhythm. Skin: Right great toe swollen, itchy, painful and discolored. Psychiatric: No anxiety. No depression. Physical examination: Vital Signs Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-labored HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: Slow gait but steady. No Kyphosis. SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit. PSYCH: Normal affect. Cooperative. Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A: Primary Diagnosis: Proximal subungual onychomycosis Differential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis Special Lab: Fungal culture confirms fungal infection. Please see below: Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy. For Week 6, please address the following: Specify when to refer the patient after therapy and why? Provide rationale. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis? Provide patient education. Keep in mind the past medical history of this patient.

PROFESSIONAL APPEARANCE PRESENTATIONYou will complete a 7- to 10-slide PowerPoint® presentation that explains what are considered professional and unprofessional attire and behaviors for your chosen career. The presentation will also include information regarding best practices for other factors related to physical appearance and behaviors (hairstyles, tattoos, accessories, jewelry, piercings, etc.). The presentation will demonstrate the importance of managing your professional image for career success. It will cover specific practices regarded as essential for professionals in your career.The PowerPoint presentation must include:A title slideA reference slide with 2–3 referencesIn-text citations, in the current APA format, located in the speaker notesExplanations of 50–100 words in the speaker notes section for all slides except the title and reference slidesImages depicting professional and unprofessional examples on all slides except the title and reference slidesWhen the assignment is complete, save your assignment in Microsoft® PowerPoint format and submit it to the Unit 2 Assignment Dropbox.Make sure that you save a copy of your assignment.ASSIGNMENT RESOURCESHow to Submit an Assignment to the DropboxUnit 2 Assignment Rubric

Comprehensive Assessment   Play Video View this breaking news announcement. You have arrived at the scene of a hostile situation at ABC Daycare in Sentinel City®.  Little detail of the situation is known.  Enter Sentinel City®, visit the area near ABC Day care.  Observe the services, routes and populations that may be involved as a result of this situation.  As the lead healthcare provider, you will oversee the situation outside of the daycare.  You need to organize and contain the situation and may be working with unknown and potential critical situations.  Observe and assess the scene and surrounding areas?  How are you going to address the scenario?  Explain the leadership skills you will use.  Using your knowledge of community health, explain the potential public health effects or environmental hazards from this situation.  For example, if disease or illness results from the release of an infectious agent.  Who are the members of the emergency management team?  Assess what services and resources that might be needed.  Explain how you would address family members or the media arriving at the scene.  Additional Instructions: All submissions should have a title page and reference page. Utilize a minimum of two scholarly resources. Adhere to grammar, spelling and punctuation criteria. Adhere to APA compliance guidelines. Adhere to the chosen Submission Option for Delivery of Activity guidelines. Submission Options: Choose One: Instructions: Paper 9 to 10-page paper. Include title and reference pages. Microsoft PowerPoint Presentation 10 to 12 slides. Add title and reference slides. Follow Rules of 7. Other media (Prezi, etc.) presentation 10 to 12 slides with speaker notes. Add title and reference slides. Follow Rules of 7. Video Presentation 9 to 10-minute video presentation. Attach reference page or include in video. Professional appearance and background. Video submissions must include a script in Word format, submitted through Turnitin for an Originality Report. Table Table with appropriate columns and headers. Include title and reference pages. Graphs or other illustrations Graphs or illustrations with appropriate labels. Include title and reference pages. Poster Poster utilizing any applicable poster template. Include visual graphics/images/other formats for visual appeal. Include appropriate title and references on poster. Note: Title and reference pages/slides do not count towards the count requirements. RUBRIC:  Reflection of Practice Analysis - Comprehensive Assessment  Description: The baccalaureate graduate nurse will apply leadership concepts, skills, and  decision-making in the provision of high-quality nursing care, healthcare team coordination,  and the oversight and accountability for care delivery in a variety of settings. Course Competencies: 2) Demonstrate professional nursing practice through the use of  research and evidence-based practice by integrating methods of research and scholarship to  prioritize diagnoses. 3) Demonstrate leadership roles on multidisciplinary teams within  healthcare organizations. QSEN Competencies: 2) Teamwork and Collaboration 3) Evidence-Based Practice  BSN Essential II Area Gold Mastery Silver Proficient  Bronze Acceptable  Acceptable  Mastery not  Demonstrated  Describe the  environment and  people around  the hostile  situation and  how these things  can potentially  impact the  situation Describes the  environment and  people around  the hostile  situation and  how these things  can potentially  impact the  situation Describes the  environment and  people around  the hostile  situation and  lists how these  things can  potentially  impact the  situation Lists the  environment and  people around  the hostile  situation but  does not define  how these things  can potentially  impact the  situation Does not address  the topic Evaluate the  leadership skills  that would be  useful in  addressing the  situation Evaluates the  leadership skills  that would be  useful in  addressing the  situation Describes the  leadership skills  that would be  useful in  addressing the  situation Lists the  leadership skills  that would be  useful in  addressing the  situation Does not address  the topic Explains the  potential public  health effect  and/or  environmental  hazards from this  situation Explains the  potential public  health effect and/or  environmental  hazards from this  situation Describes the  potential public  health effect  and/or  environmental  hazards from this  situation Lists the  potential public  health effect  and/or  environmental  hazards from this  situation Does not address  the topic Fully explains  the individuals  who make up the  emergency  response team  and the roles  they play Fully explains  the individuals  who make up the  emergency  response team  and the roles  they play Describes the  individuals who  make up the  emergency  response team  and the roles  they play Lists the  individuals who  make up the  emergency  response team  and the roles  they play Does not address  the topic Describe the 5  rights of  delegation and  Describes the 5  rights of  delegation and  Describes 3-4  rights of  delegation and  Describes 2 or  fewer rights of  delegation or  Does not address  the topichow to will  delegate to the  members of the  emergency  response team  how to will  delegate to the  members of the  emergency  response team lists how  delegation will  occur does not describe  how delegation  will occur Explains the  services and  resources that  might be needed  for the situation  and the people in  the daycare Explains the  services and  resources that  might be needed  for the situation  and the people in  the daycare Outlines the  services and  resources that  might be needed  for the situation  and the people in  the daycare Lists the services  and resources  that might be  needed for the  situation and the  people in the  daycare Does not address  the topic Explains how to  address family  and the media as  they arrive on  scene Explains how to  address family  and the media as  they arrive on  scene Describes how to  address family  and the media as  they arrive on  scene Lists how to  address family  and the media as  they arrive on  scene Does not address  the topic APA, Grammar, Spelling, and  Punctuation No errors in  APA, Spelling,  and Punctuation. One to three  errors in APA,  Spelling, and  Punctuation. Four to six errors  in APA,  Spelling, and  Punctuation. Seven or more  errors in APA,  Spelling, and  Punctuation. References Provides two or  more references. Provides two  references. Provides one  references. Provides no  references