Nursing SOAP Note1: Differential Diagnosis for Skin Conditions Differential Diagnosis for Skin Conditions Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. In this Discussion, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition. Note: Your Discussion post should be in the SOAP (Subjective, Objective, Assessment, and Plan) note format, rather than the traditional narrative style Discussion posting format . Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week's Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. To prepare: · Review the Skin Conditions document provided in this week’s Learning Resources, and select two conditions to closely examine for this Discussion. · Consider the abnormal physical characteristics you observe in the graphics you selected. How would you describe the characteristics using clinical terminologies? · Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected. · Consider which of the conditions is most likely to be the correct diagnosis, and why. A  description of the two graphics you selected (identify each graphic by number). Use clinical terminologies to explain the physical characteristics featured in each graphic. Formulate a differential diagnosis of three to five possible conditions for each. Determine which is most likely to be the correct diagnosis, and explain your reasoning. REMINDERS: Please follow the Note above. Do SOAP note format and check it out on the uploaded file the SOAP exemplar and template as your outline for your writings… No traditional essay on this assignment, again use SOAP note. Thank you. Required Resources Note: Because the information in this course is so vital, a large number of resources are provided in various formats to facilitate your competence in diagnosing a wide variety of health conditions. When multiple resources are available on the same topic, select those that best meet your personal learning needs to prepare you to accurately diagnose patient health problems. Note: To access this week's required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Readings · Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel's guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby. o Chapter 8, “Skin, Hair, an.

1. Nursing SOAP Note1: Differential Diagnosis for Skin
Conditions
Differential Diagnosis for Skin Conditions
Properly identifying the cause and type of a patient’s skin
condition involves a process of elimination known as
differential diagnosis. Using this process, a health professional
can take a given set of physical abnormalities, vital signs,
health assessment findings, and patient descriptions of
symptoms, and incrementally narrow them down until one
diagnosis is determined as the most likely cause.
In this Discussion, you will examine several visual
representations of various skin conditions, describe your
observations, and use the techniques of differential diagnosis to
determine the most likely condition.
Note:
Your Discussion post should be in the SOAP (Subjective,
Objective, Assessment, and Plan) note format, rather than the
traditional narrative style Discussion posting format
. Refer to Chapter 2 of the Sullivan text and the Comprehensive
SOAP Template in this week's Learning Resources for guidance.
Remember that not all comprehensive SOAP data are included
in every patient case.
To prepare:
·
Review the Skin Conditions document provided in this week’s
Learning Resources, and select two conditions to closely
examine for this Discussion.
·
Consider the abnormal physical characteristics you observe in
the graphics you selected. How would you describe the
characteristics using clinical terminologies?
·

2. Explore different conditions that could be the cause of the skin
abnormalities in the graphics you selected.
·
Consider which of the conditions is most likely to be the correct
diagnosis, and why.
A
description of the
two
graphics you selected (identify each graphic by number). Use
clinical terminologies to explain the physical characteristics
featured in each graphic. Formulate a differential diagnosis of
three to five
possible conditions for each. Determine which is most likely to
be the correct diagnosis, and explain your reasoning.
REMINDERS:
Please follow the Note above. Do SOAP note format and check
it out on the uploaded file the SOAP exemplar and template as
your outline for your writings… No traditional essay on this
assignment, again use SOAP note. Thank you.
Required Resources
Note:
Because the information in this course is so vital, a large
number of resources are provided in various formats to facilitate
your competence in diagnosing a wide variety of health
conditions. When multiple resources are available on the same
topic, select those that best meet your personal learning needs
to prepare you to accurately diagnose patient health problems.

3. Note:
To access this week's required library resources, please click on
the link to the Course Readings List, found in the
Course Materials
section of your Syllabus.
Readings
·
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., &
Stewart, R. W. (2015).
Seidel's guide to physical examination
(8th ed.). St. Louis, MO: Elsevier Mosby.
o
Chapter 8, “Skin, Hair, and Nails” (pp. 114-165)
This chapter reviews the basic anatomy and physiology of skin,
hair, and nails. The chapter also describes guidelines for proper
skin, hair, and nails assessments.
·
Dains, J. E., Baumann, L. C., & Scheibel, P. (2016).
Advanced health assessment and clinical diagnosis in primary
care
(5th ed.). St. Louis, MO: Elsevier Mosby.
o
Chapter 28, “Rashes and Skin Lesions” (pp. 325-343)
This chapter explains the steps in an initial examination of
someone with dermatological problems, including the type of
information that needs to be gathered and assessed.

4. Note:
Download and use the Adult Examination Checklist and the
Physical Exam Summary when you conduct your video
assessment of the skin, hair, and nails.
·
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon,
B. S., & Stewart, R. W. (2011).
Adult examination checklist: Guide for skin, hair, and nails
. In
Mosby's guide to physical examination
(7th ed.). St. Louis, MO: Elsevier Mosby.
This Adult Examination Checklist: Guide for Skin, Hair, and
Nails was published as a companion to
Seidel's guide to physical examination
(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright
Elsevier (2015). From
https://evolve.elsevier.com/
·
Seidel, H. M., Ball, J. W., Dains, J. E., Flynn, J. A., Solomon,
B. S., & Stewart, R. W. (2011).
Skin, hair, and nails physical exam summary
. In
Mosby's guide to physical examination
(7th ed.). St. Louis, MO: Elsevier Mosby.
This Skin, Hair, and Nails Physical Exam Summary was
published as a companion to
Seidel's guide to physical examination
(8th ed.), by Ball, J. W., Dains, J. E., & Flynn, J. A. Copyright
Elsevier (2015). From
https://evolve.elsevier.com/
·
Chadha, A. (2009). Assessing the skin.

5. Practice Nurse
,
38
(7), 43–48.
Retrieved from the Walden Library databases.
In this article, the author explains how to take a relevant skin
health history. In addition, the article defines common terms
used to describe skin lesions and rashes.
·
Ely, J. W., & Stone, M. S. (2010). The generalized rash: Part I.
Differential diagnosis.
American Family Physician
,
81
(6), 726–734.
Retrieved from
http://www.aafp.org/afp/2010/0315/p726.html
This article focuses on common, uncommon, and rare causes of
generalized rashes. The article also specifies tests to diagnose
generalized rashes.
·
Ely, J. W., & Stone, M. S. (2010). The generalized rash: Part II.
Diagnostic approach.
American Family Physician
,
81
(6), 735–739.

6. Retrieved from
http://www.aafp.org/afp/2010/0315/p735.html
This article revolves around the diagnosis of generalized rashes.
The authors describe clinical features that may help in
distinguishing generalized rashes.
·
Everyday Health, Inc. (2013).
Resources for dermatology and visual conditions
. Retrieved from
http://www.skinsight.com/ info/for_professionals
This interactive website allows you to explore skin conditions
according to age, gender, and area of the body.
·
Document:
Skin Conditions (Word document)
This document contains five images of different skin conditions.
You will use this information in this week’s Discussion.
·
Document:
Comprehensive SOAP Exemplar (Word document)
·
Document:
Comprehensive SOAP Template (Word document)
Media

7. Online media for
Seidel's Guide to Physical Examination
In addition to this week's media, it is highly recommended that
you access and view the online resources included with the
course text,
Seidel's Guide to Physical Examination
. Focus on the videos and animations in Chapter 8 that relate to
the assessment of the skin, hair, and nails.
The following suturing tutorials provide instruction on the basic
interrupted suture, as well as the vertical and horizontal
mattress suturing techniques:
·
Tulane Center for Advanced Medical Simulation & Team
Training. (2010, July 8).
Suturing technique.
Retrieved from
https://www.youtube.com/watch?v=c-LDmCVtL0o
·
Mikheil. (2014, April 22).
Basic suturing: Simple, interrupted, vertical mattress, horizontal
mattress
. Retrieved from
https://www.youtube.com/watch?v=MFP90aQvEVM
Optional Resources
·
LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2009).

8. DeGowin’s diagnostic examination
(9th ed.). New York, NY: McGraw Hill Medical.
o
Chapter 6, “The Skin and Nails”
In this chapter, the authors provide guidelines and procedures to
aid in the diagnosis of skin and nail disorders. The chapter
supplies descriptions and pictures of common skin and nail
conditions.
·
Ethicon, Inc. (n.d.a).
Absorbable synthetic suture material
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/absorbable_suture_chart.pdf
·
Ethicon, Inc. (2006).
Dermabond topical skin adhesive application technique
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/db_application_poster.pdf
·
Ethicon, Inc. (2001).
Ethicon needle sales types
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/needle_template.pdf
·

9. Ethicon, Inc. (n.d.b).
Ethicon sutures
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/suture_chart_ethicon.pdf
·
Ethicon, Inc. (2002).
How to care for your wound after it's treated with Dermabond
topical skin adhesive
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/db_wound_care.pdf
·
Ethicon, Inc. (2005).
Knot tying manual
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_manuals/knot_tying_manual.pdf
·
Ethicon, Inc. (n.d.c).
Wound closure manual
. Retrieved from
http://academicdepartments.musc.edu/surgery/education/residen
t_info/supplement/suture_m