TASK 5 NURSE IN OUTPATIENTS DEPARTMENT OF LARGE HOSPITAL

PATIENT: STEPHANIE EMERSON-ECZEMA

Patient’s Name           :           Stephanie Emerson 8 year old

Date of Birth              :           22 January 2002

Social History             :           Lives at home with parents. Loves swimming, gymnastics, netball

Medical History        :           No major illness; get hayfever during spring time

Medication History     :           Nil

Family History          :           Father gets asthma and is one steroid medication

Current problem, 10 October 2009    : Stephanie’s eczema has flared up. Has been on gluten free diet. Eczema rash all over the trunk of her body as well as arm/knee joints. Now advised to use Tubifast wet wrapping with an emollient. 50% white soft paraffin and 50% emulsifying ointment. Suggested Epaderm. In addition to Tubifast wet wrapping on toso, use Lociod Lip cream atopically on crease-folds of elbows and knees. To be monitored by Community Nurse

Previous History21 December 2008 :           Hayfever. Temp 39.5o c P. 85 BP 150/90

Given water-based Nasacort AQ (Triamcinolone acetonide), to be sprayed into nasal passage once a day (mornings)

3 February 2009        :           Fuss like discharge from nose: cannot smell anything

Headache above eyes. diag: Sinusitis Amoxycilin-10 days course. Plus Nasacort AQ

26 September 2009:Mother brought Stephanie into surgery-skin rash on back of knees and inside elbows.

Diag: Eczema. Advised to see a dietitian re suitable diet. Atopic hydrocortisone cream. Lociod Lipocream.

Writing Task: Write a letter to the Community Nurse, Springvale Community Health Centre, 1075 Waverley Road, Springvale, Vic 3171. Outline the treatment Stephanie has had so far and request the Community Nurse to visit Stephanie’s home to make sure her mother is applying the cream and tubifast correctly. Community Nurse to remind patient’s mother to use Tubifast as a dry wrapping (With atopic Lociod Lipcream) and as a wet wrapping at night when Stephanie goes to bed At night – use Epaderm. No cats or dogs allowed in Stephanie’s bedroom. Follow gluten free diet. Review household furnishings no carpets or dust catching furniture would be best

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