The case study provides the the first two steps of

Subjective (S): CC: chief complaint – “This rash is getting worse, even with the creams you gave me”. HPI: history of present illness – Patient is an 11-year-old black female who presents with complaint of worsening rash on bilateral arms and increased itching and flakiness on her scalp. PMH: past medical history – She has a past medical history of mild eczema with no prior treatment needed before this fall. There is no reported history of asthma. Allergies: None Medications: Hydrocortisone topical cream 2.5% to be applied twice daily to affected area. Social history: She lives at home with her mother, father, and younger brother. She is currently attending online schooling due to the pandemic. She has two cats as well in the home. Family history: Mother reports that the patient’s younger brother also suffers from eczema and asthma, both are controlled. She reports they have never had to treat her brother’s eczema and he uses a rescue inhaler for his asthma. General: She reports having a rash on her arms for the last month that is worsening. She reports trying “the cream that was prescribed” with little to no improvement. She also states that her scalp is itchy and flaking over the last month. Her mother reports she has always had a flaky scalp in the colder months, but the itching is new. Pain: She reports that the area of her arms is very itchy, they are also painful most of the time. She reports the pain as a 7/10 and a burning feeling along with the severe itching. She reports that nothing makes the pain better and the only things that feels better is when she itches. She reports that right after she itches then it starts to burn worse and itch more. She reports this itching and burning starting “sometime in October”. She reports that nothing makes it better. She reports that scratching makes it worse, it burns more. She says that putting on the cream makes it hurt worse (burn). Review the Subjective and Objective elements of the attached document to determine the appropriate diagnoses to assign (‘A’) and construct an Evidence-based ‘Plan”. Use your ‘model’ thinking as you assign the diagnoses including in parentheses behind each diagnosis the pertinent positives and pertinent negatives that you are using to support the diagnoses you assigned Elements of the ‘plan’ need to reflect current EBP and CPGs Using the following guidelines: Diagnostic, Plan, Therapeutic, Educational and Consultation/follow-up

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