course material

1. week 4 assign 1 SOAP 6512
Assignment 1: Lab Assignment: Differential Diagnosis for Skin ConditionsPhoto Credit:
Getty Images/iStockphotoProperly 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 Lab
Assignment, 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.To PrepareReview the Skin Conditions document provided in this
week’s Learning Resources, and select one condition to closely examine for this Lab
Assignment.Consider the abnormal physical characteristics you observe in the graphic 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.Search the Walden library for one evidence-based practice, peer-reviewed article
based on the skin condition you chose for this Lab Assignment.Review the Comprehensive
SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your
SOAP note.Download the SOAP Template found in this week’s Learning Resources, and use
this template to complete this Lab Assignment.The Lab AssignmentChoose one skin
condition graphic (identify by number in your Chief Complaint) to document your
assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather
than the traditional narrative style. 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.Use clinical
terminologies to explain the physical characteristics featured in the graphic. Formulate a
differential diagnosis of three to five possible conditions for the skin graphic that you chose.
Determine which is most likely to be the correct diagnosis and explain your reasoning using
at least three different references, one reference from current evidence-based literature
from your search and two different references from this week’s Learning
Resources.Learning ResourcesRequired Readings (click to expand/reduce)Ball, J. W., Dains,
J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical
examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Chapter
9, “Skin, Hair, and Nails”This chapter reviews the basic anatomy and physiology of skin,

2. hair, and nails. The chapter also describes guidelines for proper skin, hair, and nails
assessments.Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA:
F. A. Davis.Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R.
Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via
the Copyright Clearance Center.This section explains the procedural knowledge needed
prior to performing various dermatological procedures.Chapter 1, “Punch Biopsy”Chapter 2,
“Skin Biopsy”Chapter 10, “Nail Removal”Chapter 15, “Skin Lesion Removals: Keloids, Moles,
Corns, Calluses”Chapter 16, “Skin Tag (Acrochordon) Removal” Chapter 22, “Suture
Insertion”Chapter 24, “Suture Removal”Dains, J. E., Baumann, L. C., & Scheibel, P.
(2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St.
Louis, MO: Elsevier Mosby.Credit Line: Advanced Health Assessment and Clinical Diagnosis
in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by
Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.Chapter 28,
“Rashes and Skin Lesions”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.Note: Download and use the Student Checklist and the Key Points
when you conduct your assessment of the skin, hair, and nails in this Week’s Lab
Assignment.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Skin,
hair, and nails: Student checklist. In Seidel’s guide to physical examination (9th ed.). St.
Louis, MO: Elsevier Mosby.Credit Line: Seidel’s Guide to Physical Examination, 9th Edition
by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by
Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the
Copyright Clearance Center.Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.
(2019). Skin, hair, and nails: Key points. In Seidel’s guide to physical examination: An
interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby.Credit Line: Seidel’s
Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B.
S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission
of Elsevier Health Sciences via the Copyright Clearance Center.Sullivan, D. D. (2019). Guide
to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.Chapter 2, “The
Comprehensive History and Physical Exam” (Previously read in Weeks 1 and 3)VisualDx.
(n.d.). Clinical decision support. Retrieved June 11, 2019, from
http://www.skinsight.com/info/for_professionalsThis interactive website allows you to
explore skin conditions according to age, gender, and area of the body.Clothier, A. (2014).
Assessing and managing skin tears in older people. Nurse Prescribing, 12(6), 278–
282.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)Shadow Health Support and Orientation ResourcesUse
the following resources to guide you through your Shadow Health orientation as well as
other support resources:Frey, C. [Chris Frey]. (2015, September 4). Student orientation
[Video file]. Retrieved from https://www.youtube.com/watch?v=Rfd_8pTJBkYDocument:
Shadow Health Support and Orientation Resources (PDF)Shadow Health. (n.d.). Shadow
Health help desk. Retrieved from https://support.shadowhealth.com/hc/en-us Document:

3. Shadow Health. (2014). Useful tips and tricks (Version 2) (PDF)Document: Shadow Health
Nursing Documentation Tutorial (Word document)Document: Student Acknowledgement
Form (Word document)Note: You will sign and date this form each time you complete your
DCE Assignment in Shadow Health to acknowledge your commitment to Walden
University’s Code of Conduct.Document: DCE (Shadow Health) Documentation Template for
Health History (Word document)Use this template to complete your Assignment 2 for this
week. Optional ResourcesLeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s
diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical.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
https://web.archive.org/web/20170215015223/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/absorbable_suture_chart.pdf
Ethicon, Inc. (2006). Dermabond topical skin adhesive application technique. Retrieved
from
https://web.archive.org/web/20150921174121/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/db_application_poster.pdfEt
hicon, Inc. (2001). Ethicon needle sales types. Retrieved from
https://web.archive.org/web/20150921171922/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/needle_template.pdfEthicon,
Inc. (n.d.-b). Ethicon sutures. Retrieved from
https://web.archive.org/web/20150921202525/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/suture_chart_ethicon.pdfEthi
con, Inc. (2002). How to care for your wound after it’s treated with Dermabond topical skin
adhesive. Retrieved from
https://web.archive.org/web/20150926002534/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/db_wound_care.pdfEthicon,
Inc. (2005). Knot tying manual. Retrieved from
https://web.archive.org/web/20160915214422/http://academicdepartments.musc.edu/s
urgery/education/resident_info/supplement/suture_manuals/knot_tying_manual.pdfEthic
on, Inc. (n.d.-c). Wound closure manual. Retrieved from
http://www.uphs.upenn.edu/surgery/Education/facilities/measey/Wound_Closure_Manua
l.pdf Required Media (click to expand/reduce)Module 3 IntroductionDr. Tara Harris
reviews the overall expectations for Module 3. Consider how you will manage your time as
you review your media and Learning Resources for your Discussions, Case Study Lab
Assignments, DCE Assignments, and your Midterm exam (12m).Accessible player –
Downloads–Download Video w/CCDownload AudioDownload TranscriptSkin, Hair, and
Nails – Week 4 (19m)Accessible player –Downloads–Download Video w/CCDownload
AudioDownload TranscriptOnline media for Seidel’s Guide to Physical ExaminationIn
addition to this week’s media, it is highly recommended that you access and view the online
resources included with the 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

4. nails.Note: To access the online resources included with the text, you need to complete the
FREE online registration that is located at
https://evolve.elsevier.com/cs/product/9780323172660?role=student .To Register to
View the ContentGo to
https://evolve.elsevier.com/cs/product/9780323172660?role=studentEnter the name of
the textbook, Seidel’s Guide to Physical Examination (name of text without the edition
number) in the Search textbox.Complete the registration process.To View the Content for
this TextGo to https://evolve.elsevier.com/Click on Student Site.Type in your username and
password.Click on the Login button.Click on the plus sign icon for Resources on the left side
of the screen.Click on the name of the textbook for this course.Expand the menu on the left
to locate all the chapters.Navigate to the desired content (checklists, videos, animations,
etc.).Note: Clicking on the URLs in the APA citations for the Resources from the textbook
will not link directly to the desired online content. Use the online menu to navigate to the
desired content.Suturing TutorialsThe following suturing tutorials provide instruction on
the basic interrupted suture, as well as the vertical and horizontal mattress suturing
techniquesTulane Center for Advanced Medical Simulation & Team Training. (2010, July 8).
Suturing technique [Video file]. Retrieved from https://www.youtube.com/watch?v=c-
LDmCVtL0oNote: Approximate length of this media program is 5 minutes.Mikheil. (2014,
April 22). Basic suturing: Simple, interrupted, vertical mattress, horizontal mattress [Video
file]. Retrieved from https://www.youtube.com/watch?v=MFP90aQvEVMNote:
Approximate length of this media program is 9 minutes.Incision and Drainage of an Abscess
(a common procedure in primary care)New England Journal of Medicine (NEJM). (2013,
September 30). NEJM abscess incision and drainage [Video file]. Retrieved from
https://www.youtube.com/watch?v=MwgNdrA18fM&list=PL9UKTUFtRDcNq4–
Vf2NYfUANEyObfeNm&index=8Note: Approximate length of this media program is 10
minutes.Dermablade Use for Shave BiopsiesDermablade®. (2012, November 9).
PersonnaBlades [Video file]. Retrieved from
https://www.youtube.com/watch?v=D8u1Y18L9DQNote: Approximate length of this media
program is 5 minutes.Welcome to week 4We are entering week 4. Students have 2
assignments due this week. You will choose a lesion to document the SOAP note and
secondly, this week is our first Shadow Health Assignment. There are several student tips,
how to upload the lab pass, etc. located in the course. Regarding the SOAP notes, there is
not enough information. I advise you to make up the information that is not there (ie. Health
hx, social hx, etc). This will allow you to critically think as you develop the notes. You need
to know that the DCE score is not the only score that counts as your grade, it is only a
portion of the grade. You must complete the documentation portion. Also, we have noted
that in SH, the ROS is not located in the documentation portion but is located in the
subjective data collection portion. Remember to document as the SOAP order. I advise you
to review my SOAP document send last week for guidance.Last week we engulfed in great
conversation on the risks of our findings about growth, measurements, and nutrition of
children and their families. As practitioners, it’s important to communicate professionally,
ask the right questions, and guide families as they strive to have healthier and happy lives.
This week we will begin to review assessments of body systems. Skin, Hair, and Nails will be

5. covered. I encourage you to perform the assessment of Skin, Hair, and Nails so that you may
be proficient with it for the overall assessment. You are able to access the check lists by
enrolling into the evolve website in your resources. You first assignment for this week is to
be written in a SOAP Note format (NO NARRATIVES). There is a template/sample for you to
follow posted in your announcements at the beginning of the semester. You will need to put
in the missing information in the note (some may be made up ie meds, hx, parts of the ROS
and PE). In the Assessment/Plan, you will document your differential diagnoses as per the
assignment. I will comment on your notes and if needed, send you an email if I need to help
you with them more.Assignment 1:The Lab Assignment· Choose one skin condition graphic
(identify by number in your Chief Complaint) to document your assignment in the SOAP
(Subjective, Objective, Assessment, and Plan) note format rather than the traditional
narrative style. 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.· Use clinical terminologies to
explain the physical characteristics featured in the graphic. Formulate a differential
diagnosis of three to five possible conditions for the skin graphic that you chose. Determine
which is most likely to be the correct diagnosis and explain your reasoning using at least
three different references, one reference from current evidence-based literature from your
search and two different references from this week’s Learning Resources.