Respond to Peer from an FNP perspective
Please respond to your peer’s posts, from an FNP perspective. To ensure that your responses are substantive, use at least two of these prompts:
- Do you agree with your peers’ assessment?
- Take an opposing view to a peer and present a logical argument supporting an alternate opinion.
- Share your thoughts on how you support their opinion and explain why.
- Present new references that support your opinions.
Please be sure to validate your opinions and ideas with citations and references in APA format. Substantive means that you add something new to the discussion, you aren’t just agreeing. This is also a time to ask questions or offer information surrounding the topic addressed by your peers. Personal experience is appropriate for a substantive discussion and should be correlated to the literature.Be sure to review your APA errors in your reference list, specifically you have capitalization errors in some words of the titles. Also, be sure you are italicizing titles of online sources.
- You are evaluating a 6-month-old with recurrent eczema. Parents want to know what they can do to minimize skin irritation. What will you recommend?
Atopic dermatitis, also known as atopic eczema, is a chronic inflammatory skin condition characterized by pruritic, erythematous, and scaly skin lesions often localized to the flexural surfaces of the body (Berke, Singh, & Guralnick , 2012). In infants it may be common to see on the face and less common on the hands and feet (Berke et al., 2012). This is partially exacerbated by drooling and the often wiping od the infants face causing the skin to become dry (Berke et al., 2012). Early diagnosis and treatment may prevent significant morbidity from sleep disturbances, chronic post-inflammatory skin changes, scarring from picking and scratching, and the development of secondary skin infections with Staphylococcus, Streptococcus, and herpes species (Berke et al., 2012). Diagnostic criteria include itchy skin, with at least three of the following: history of asthma or allergic rhinitis; history of flexural involvement; history of generalized dry skin; onset of rash before two years of age; and visible flexural dermatitis (Berke et al., 2012). It is helpful to ask patients about the number of days per week they experience symptoms, such as pruritus, bleeding, oozing clear fluid, or dry and flaky skin (Berke et al., 2012).
Management includes identification of possible triggers, use of emollients for routine skin hydration, topical corticosteroids for flare up management, and possible sedative antihistamines to prevent night time itching (Allmon, Deane, & Martin, 2016). Patients with atopic dermatitis should liberally apply emollients to the entire body whether or not active symptoms are present (Allmon et al., 2016). A randomized controlled trial of infants with moderate to severe atopic dermatitis revealed that regular emollient use reduced the need for topical corticosteroid use and improved symptoms (Allmon et al., 2016). Thick creams that are low in water (e.g., Cetaphil, Eucerin) or ointments (e.g., Aquaphor, petroleum jelly) are preferred (Allmon et al., 2016). Topical corticosteroids are first-line treatment for atopic dermatitis flare-ups (Allmon et al., 2016). To avoid atrophy, mild-potency corticosteroids are recommended for the face, neck, axillae, groin, and flexor surfaces (Allmon et al., 2016). Referral to a dermatologist is warranted if the practitioner is uncertain diagnosis, attempts at management have not controlled the symptoms, the patient has atopic dermatitis on the face that has not responded to treatment, the patient has frequent flare-ups or severe atopic dermatitis, the patient requires systemic therapies for flare-ups or maintenance, the condition is causing significant psychosocial disturbances, and contact allergic dermatitis is suspected (Burns et al., 2017).
Allmon, A., Deane, K., & Martin, K. (2016). Common Skin Rashes in Children. American Family Physician . Retrieved from https://www.aafp.org/afp/2015/0801/p211.html.
Berke, R., Singh, A., & Guralnick , G. (2012). Atopic Dermatitis: An Overview. American Family Physician .Retrieved from https://www.aafp.org/afp/2012/0701/p35.html.
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., Garzon, D. L., & Gaylord, N.M. (2017). Pediatric Primary Care. Retrieved from https://bookshelf.vitalsource.com
Eczema (eg-zuh-MUH) is the name for a group of conditions that cause the skin to become red, itchy and inflamed (National, 2019). There are several types of eczema (National, 2019). Atopic dermatitis, contact dermatitis, dyshidrotic eczema and seborrheic dermatitis, also known as “cradle cap” in infants, are the most common types that affect children (National, 2019). The exact cause of eczema is unknown. Researchers do know that children who develop eczema do so because of a combination of genes and environmental triggers (National, 2019). When something outside the body “switches on” the immune system, skin cells don’t behave as they should causing flare ups (National, 2019). Eczema presents itself differently in every child such in a child the 6 months to 12 months of age eczema may only appear on the elbows and knees. These places can be infected easily due to the fact that the child is learning how to crawl. If the eczema rash becomes infected, it may form a yellow crust, or very small, “pus bumps” on the skin ( National, 2019). This may scare the parents and irritate the child. The treatment or prevention technique that I would suggest to the parents to monitor triggers that may cause the child symptoms to worsen, this can help the patient avoid these triggers. In addition to this treatment I would suggest that the family develop bath time routine that involves moisturizing lotions to protect skin and lock in moisture. The parents should use OTC and prescription medication consistently and as prescribed to curb symptoms. Although eczema isn’t a curable disorder the treatments that I suggested can keep the flareups under control and make the child’s life more pleasurable.
National Eczema Foundation (2019). Understanding your child’s eczema what is eczema? Retrieved from https://nationaleczema.org/eczema/children/
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