Description
Please respond to discussion below using current APA edition and 2 scholarly references. Must be at least 150 words.
This was the first week of my pediatric rotation and it was a very different experience from my prior rotations. I would say some challenges that I encountered was the transition from adults to pediatrics. They are very different populations and I have no prior pediatrics experience as a nurse, so it was a lot of adjusting. Some challenges are also having to remember that the medication dosages are very different. Successes that I have faced this week was interacting with and getting to know the office staff as well as learning a lot of valuable information from the doctor.
Assessment, signs/symptoms, and plan of care
This week, I had a 5-year-old patient who came into the office with complaints of a rash and breaking out for about 6 days. She and her father reported that the rash started on her face and neck and then progressed to her chest, back, and armpits. The girl reported that her armpits have been itching her. Upon assessment, some signs, and symptoms we noted was that there were indeed rashes but no redness, just dry and flaky areas, and cracked skin. Other signs were raised bumps and darkening in some areas of the skin. The patient was also scratching her armpits and body, so it was evident that she was experiencing itchiness. The plan of care for this patient included instructions on moisturizing the skin and washing clothes right after buying them. The doctor also informed the patient and her father that if the rash persists in three days, to take Benadryl.
Differential Diagnosis
Differential diagnoses for this patient include contact dermatitis, psoriasis, and scabies. Contact dermatitis can be result of a reaction through a substance and results in itchiness and swelling. Psoriasis can be a differential diagnosis due to itchiness and may present the same in addition to scaly patches. Scabies are a differential diagnosis due to intense itchiness, rash, and infestation of the skin (Wollenberg et al., 2023).
Health promotion intervention
Health promotion interventions for this patient includes targeting rehydration of the skin, reducing inflammation, control of itch, and prevention or treatment of infection. Patients should avoid triggers and irritants. Regular use of emollients after bathing or showring may help with the rash and prevents the skin from drying. In addition, antihistamines or topical steroids can be used if there is no relief. Unscented or mild and gentle soap should be used instead of scented dyes and perfumes. Patients should also avoid constant scratching the skin to avoid irritation. Patients should also be encouraged to talk to a provider regarding mood issues regarding their condition (Singleton et al., 2021).
Learning Experience
This week, I learned so many things that will help me as an advanced practice nurse. A lot of these included ICD and CPT codes which is essential to know as a provider. I learned the interventions for diaper rash and how one of the most underdiagnosed problems in pediatrics related to ear pain is eustachian tube dysfunction and dental issues which I thought was very interesting to know. This week, I learned how different pediatrics and adult primary care is. When it comes to children, we need to be more cautious when administering medications because it is based on their specific weight rather than a one size fit all. I look forward to learning more throughout this rotation.
